How much rates vary
Facilitymedian $661 · 10th to 90th $575 to $1,445Professionalmedian $646 · 10th to 90th $427 to $1,000
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 $524.81 Median $660.69 Typical High $724.44 | Professional | None | $524.81 | $660.69 | $724.44 |
BCBS Idaho Setting Facility Modifier None Typical Low $575.44 Median $691.83 Typical High $1,445.44 | Facility | None | $575.44 | $691.83 | $1,445.44 |
BCBS Idaho Setting Professional Modifier None Typical Low $426.58 Median $954.99 Typical High $1,000.00 | Professional | None | $426.58 | $954.99 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $676.08 | Facility | None | $630.96 | $630.96 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $630.96 | Professional | None | $467.74 | $467.74 | $630.96 |
Moda Health Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $660.69 | Facility | None | $426.58 | $602.56 | $660.69 |
Moda Health Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $660.69 | Professional | None | $537.03 | $645.65 | $660.69 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $645.65 Typical High $758.58 | Professional | None | $30.20 | $645.65 | $758.58 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $741.31 Median $758.58 Typical High $36,307.81 | Facility | None | $741.31 | $758.58 | $36,307.81 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $42,657.95 | Professional | None | $645.65 | $758.58 | $42,657.95 |
Regence BlueShield Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $870.96 | Facility | None | $575.44 | $575.44 | $870.96 |
Regence BlueShield Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $645.65 | Professional | None | $426.58 | $426.58 | $645.65 |
Select Health Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $630.96 | Facility | None | $616.60 | $616.60 | $630.96 |
Select Health Setting Professional Modifier None Typical Low $588.84 Median $794.33 Typical High $912.01 | Professional | None | $588.84 | $794.33 | $912.01 |
United Setting Professional Modifier None Typical Low $457.09 Median $478.63 Typical High $616.60 | Professional | None | $457.09 | $478.63 | $616.60 |
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 $263.03 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $263.03 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $104.71 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $77.62 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $52.48 | $66.07 | $66.07 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $660.69 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $588.84 | $660.69 | $691.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $263.03 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $263.03 | $331.13 | $331.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $104.71 | $131.83 | $131.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $77.62 | $100.00 | $100.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $52.48 | $66.07 | $66.07 |
Where Idaho sits
The same service costs 2.2 times more in Kansas 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· 20th of 51
$646
KS $1,000UT $457
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.