How much rates vary
Facilitymedian $324 · 10th to 90th $191 to $550Professionalmedian $295 · 10th to 90th $138 to $427
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 $223.87 Median $295.12 Typical High $295.12 | Professional | None | $223.87 | $295.12 | $295.12 |
BCBS Idaho Setting Facility Modifier None Typical Low $269.15 Median $323.59 Typical High $549.54 | Facility | None | $269.15 | $323.59 | $549.54 |
BCBS Idaho Setting Professional Modifier None Typical Low $239.88 Median $354.81 Typical High $380.19 | Professional | None | $239.88 | $354.81 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $208.93 | Facility | None | $190.55 | $190.55 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $190.55 | Professional | None | $138.04 | $138.04 | $190.55 |
Moda Health Setting Facility Modifier None Typical Low $97.72 Median $295.12 Typical High $338.84 | Facility | None | $97.72 | $295.12 | $338.84 |
Moda Health Setting Professional Modifier None Typical Low $223.87 Median $309.03 Typical High $354.81 | Professional | None | $223.87 | $309.03 | $354.81 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $257.04 Typical High $295.12 | Professional | None | $30.20 | $257.04 | $295.12 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $269.15 Median $426.58 Typical High $20,417.38 | Facility | None | $269.15 | $426.58 | $20,417.38 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $338.84 Median $426.58 Typical High $23,988.33 | Professional | None | $338.84 | $426.58 | $23,988.33 |
Regence BlueShield Setting Facility Modifier None Typical Low $316.23 Median $323.59 Typical High $489.78 | Facility | None | $316.23 | $323.59 | $489.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $354.81 | Professional | None | $239.88 | $239.88 | $354.81 |
Select Health Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $436.52 | Facility | None | $338.84 | $338.84 | $436.52 |
Select Health Setting Professional Modifier None Typical Low $223.87 Median $338.84 Typical High $371.54 | Professional | None | $223.87 | $338.84 | $371.54 |
United Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $173.78 | Facility | None | $125.89 | $125.89 | $173.78 |
United Setting Professional Modifier None Typical Low $141.25 Median $151.36 Typical High $223.87 | Professional | None | $141.25 | $151.36 | $223.87 |
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 $112.20 Median $147.91 Typical High $147.91 | Professional | 52 · Reduced service | $112.20 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $58.88 Typical High $58.88 | Professional | 53 · Discontinued | $45.71 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $43.65 Typical High $43.65 | Professional | 55 · Aftercare only | $33.88 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $29.51 Typical High $29.51 | Professional | 56 · Pre-op care only | $22.39 | $29.51 | $29.51 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $251.19 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $223.87 | $251.19 | $263.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $112.20 Median $147.91 Typical High $147.91 | Professional | 52 · Reduced service | $112.20 | $147.91 | $147.91 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $58.88 Typical High $58.88 | Professional | 53 · Discontinued | $45.71 | $58.88 | $58.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $43.65 Typical High $43.65 | Professional | 55 · Aftercare only | $33.88 | $43.65 | $43.65 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $29.51 Typical High $29.51 | Professional | 56 · Pre-op care only | $22.39 | $29.51 | $29.51 |
Where Idaho sits
The same service costs 2.7 times more in Hawaii 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
$295
HI $372DE $138
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.