How much rates vary
Facilitymedian $661 · 10th to 90th $457 to $1,096Professionalmedian $589 · 10th to 90th $309 to $871
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier None Typical Low $457.09 Median $588.84 Typical High $588.84 | Professional | None | $457.09 | $588.84 | $588.84 |
BCBS Idaho Setting Facility Modifier None Typical Low $588.84 Median $660.69 Typical High $1,096.48 | Facility | None | $588.84 | $660.69 | $1,096.48 |
BCBS Idaho Setting Professional Modifier None Typical Low $478.63 Median $724.44 Typical High $758.58 | Professional | None | $478.63 | $724.44 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $457.09 | Facility | None | $436.52 | $436.52 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $436.52 | Professional | None | $316.23 | $316.23 | $436.52 |
Moda Health Setting Facility Modifier None Typical Low $457.09 Median $588.84 Typical High $691.83 | Facility | None | $457.09 | $588.84 | $691.83 |
Moda Health Setting Professional Modifier None Typical Low $457.09 Median $616.60 Typical High $724.44 | Professional | None | $457.09 | $616.60 | $724.44 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $501.19 Typical High $588.84 | Professional | None | $30.20 | $501.19 | $588.84 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $691.83 Median $870.96 Typical High $41,686.94 | Facility | None | $691.83 | $870.96 | $41,686.94 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $48,977.88 | Professional | None | $691.83 | $870.96 | $48,977.88 |
Regence BlueShield Setting Facility Modifier None Typical Low $645.65 Median $660.69 Typical High $1,000.00 | Facility | None | $645.65 | $660.69 | $1,000.00 |
Regence BlueShield Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $724.44 | Professional | None | $478.63 | $478.63 | $724.44 |
Select Health Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $707.95 | Facility | None | $691.83 | $691.83 | $707.95 |
Select Health Setting Professional Modifier None Typical Low $446.68 Median $691.83 Typical High $758.58 | Professional | None | $446.68 | $691.83 | $758.58 |
United Setting Professional Modifier None Typical Low $288.40 Median $309.03 Typical High $389.05 | Professional | None | $288.40 | $309.03 | $389.05 |
9 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $229.09 Median $295.12 Typical High $295.12 | Professional | 52 · Reduced service | $229.09 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $91.20 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $89.13 Typical High $89.13 | Professional | 55 · Aftercare only | $69.18 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $58.88 Typical High $58.88 | Professional | 56 · Pre-op care only | $45.71 | $58.88 | $58.88 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $512.86 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $446.68 | $512.86 | $537.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $229.09 Median $295.12 Typical High $295.12 | Professional | 52 · Reduced service | $229.09 | $295.12 | $295.12 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $91.20 | $117.49 | $117.49 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $89.13 Typical High $89.13 | Professional | 55 · Aftercare only | $69.18 | $89.13 | $89.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $58.88 Typical High $58.88 | Professional | 56 · Pre-op care only | $45.71 | $58.88 | $58.88 |
Where Idaho sits
The same service costs 2.3 times more in Montana than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Idaho· 12th of 51
$589
MT $741DE $316
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.