How much rates vary
Facilitymedian $234 · 10th to 90th $200 to $490Professionalmedian $219 · 10th to 90th $148 to $339
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 $177.83 Median $229.09 Typical High $229.09 | Professional | None | $177.83 | $229.09 | $229.09 |
BCBS Idaho Setting Facility Modifier None Typical Low $199.53 Median $309.03 Typical High $489.78 | Facility | None | $199.53 | $309.03 | $489.78 |
BCBS Idaho Setting Professional Modifier None Typical Low $147.91 Median $323.59 Typical High $338.84 | Professional | None | $147.91 | $323.59 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $239.88 | Facility | None | $213.80 | $213.80 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $213.80 | Professional | None | $158.49 | $158.49 | $213.80 |
Moda Health Setting Facility Modifier None Typical Low $104.71 Median $204.17 Typical High $245.47 | Facility | None | $104.71 | $204.17 | $245.47 |
Moda Health Setting Professional Modifier None Typical Low $177.83 Median $218.78 Typical High $229.09 | Professional | None | $177.83 | $218.78 | $229.09 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $223.87 Typical High $263.03 | Professional | None | $30.20 | $223.87 | $263.03 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $229.09 Median $263.03 Typical High $12,589.25 | Facility | None | $229.09 | $263.03 | $12,589.25 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $208.93 Median $263.03 Typical High $14,791.08 | Professional | None | $208.93 | $263.03 | $14,791.08 |
Regence BlueShield Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $295.12 | Facility | None | $199.53 | $199.53 | $295.12 |
Regence BlueShield Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $218.78 | Professional | None | $147.91 | $147.91 | $218.78 |
Select Health Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $478.63 | Facility | None | $208.93 | $208.93 | $478.63 |
Select Health Setting Professional Modifier None Typical Low $199.53 Median $263.03 Typical High $309.03 | Professional | None | $199.53 | $263.03 | $309.03 |
United Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $234.42 | Facility | None | $213.80 | $213.80 | $234.42 |
United Setting Professional Modifier None Typical Low $147.91 Median $162.18 Typical High $239.88 | Professional | None | $147.91 | $162.18 | $239.88 |
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 $89.13 Median $114.82 Typical High $114.82 | Professional | 52 · Reduced service | $89.13 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $35.48 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $26.92 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $17.78 | $22.91 | $22.91 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $229.09 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $204.17 | $229.09 | $239.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $114.82 Typical High $114.82 | Professional | 52 · Reduced service | $89.13 | $114.82 | $114.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $35.48 | $45.71 | $45.71 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $26.92 | $33.88 | $33.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $17.78 | $22.91 | $22.91 |
Where Idaho sits
The same service costs 2.9 times more in Hawaii than in Utah. 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· 11th of 51
$224
HI $437UT $151
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.