How much rates vary
Facilitymedian $513 · 10th to 90th $331 to $851Professionalmedian $468 · 10th to 90th $240 to $676
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 $338.84 Median $467.74 Typical High $467.74 | Professional | None | $338.84 | $467.74 | $467.74 |
BCBS Idaho Setting Facility Modifier None Typical Low $416.87 Median $512.86 Typical High $851.14 | Facility | None | $416.87 | $512.86 | $851.14 |
BCBS Idaho Setting Professional Modifier None Typical Low $380.19 Median $562.34 Typical High $588.84 | Professional | None | $380.19 | $562.34 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $363.08 | Facility | None | $331.13 | $331.13 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $331.13 | Professional | None | $239.88 | $239.88 | $331.13 |
Moda Health Setting Facility Modifier None Typical Low $169.82 Median $467.74 Typical High $537.03 | Facility | None | $169.82 | $467.74 | $537.03 |
Moda Health Setting Professional Modifier None Typical Low $354.81 Median $467.74 Typical High $562.34 | Professional | None | $354.81 | $467.74 | $562.34 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $407.38 Typical High $467.74 | Professional | None | $30.20 | $407.38 | $467.74 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $426.58 Median $676.08 Typical High $32,359.37 | Facility | None | $426.58 | $676.08 | $32,359.37 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $38,018.94 | Professional | None | $537.03 | $676.08 | $38,018.94 |
Regence BlueShield Setting Facility Modifier None Typical Low $501.19 Median $512.86 Typical High $776.25 | Facility | None | $501.19 | $512.86 | $776.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $562.34 | Professional | None | $380.19 | $380.19 | $562.34 |
Select Health Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $691.83 | Facility | None | $537.03 | $537.03 | $691.83 |
Select Health Setting Professional Modifier None Typical Low $354.81 Median $537.03 Typical High $588.84 | Professional | None | $354.81 | $537.03 | $588.84 |
United Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $363.08 | Facility | None | $354.81 | $354.81 | $363.08 |
United Setting Professional Modifier None Typical Low $245.47 Median $263.03 Typical High $389.05 | Professional | None | $245.47 | $263.03 | $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 $177.83 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $177.83 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $70.79 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $53.70 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $35.48 | $46.77 | $46.77 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $398.11 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $354.81 | $398.11 | $416.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $177.83 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $177.83 | $234.42 | $234.42 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $70.79 | $93.33 | $93.33 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $53.70 | $69.18 | $69.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $35.48 | $46.77 | $46.77 |
Where Idaho sits
The same service costs 4.1 times more in Hawaii than in Florida. 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
$468
HI $1,000FL $245
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.