How much rates vary
Facilitymedian $646 · 10th to 90th $417 to $1,096Professionalmedian $575 · 10th to 90th $302 to $851
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 $416.87 Median $575.44 Typical High $575.44 | Professional | None | $416.87 | $575.44 | $575.44 |
BCBS Idaho Setting Facility Modifier None Typical Low $524.81 Median $645.65 Typical High $1,096.48 | Facility | None | $524.81 | $645.65 | $1,096.48 |
BCBS Idaho Setting Professional Modifier None Typical Low $467.74 Median $707.95 Typical High $741.31 | Professional | None | $467.74 | $707.95 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $436.52 | Facility | None | $416.87 | $416.87 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $416.87 | Professional | None | $309.03 | $309.03 | $416.87 |
Moda Health Setting Facility Modifier None Typical Low $194.98 Median $575.44 Typical High $676.08 | Facility | None | $194.98 | $575.44 | $676.08 |
Moda Health Setting Professional Modifier None Typical Low $446.68 Median $575.44 Typical High $707.95 | Professional | None | $446.68 | $575.44 | $707.95 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $489.78 Typical High $575.44 | Professional | None | $30.20 | $489.78 | $575.44 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $537.03 Median $851.14 Typical High $40,738.03 | Facility | None | $537.03 | $851.14 | $40,738.03 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $676.08 Median $851.14 Typical High $47,863.01 | Professional | None | $676.08 | $851.14 | $47,863.01 |
Regence BlueShield Setting Facility Modifier None Typical Low $630.96 Median $645.65 Typical High $977.24 | Facility | None | $630.96 | $645.65 | $977.24 |
Regence BlueShield Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $707.95 | Professional | None | $467.74 | $467.74 | $707.95 |
Select Health Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $870.96 | Facility | None | $676.08 | $676.08 | $870.96 |
Select Health Setting Professional Modifier None Typical Low $436.52 Median $676.08 Typical High $741.31 | Professional | None | $436.52 | $676.08 | $741.31 |
United Setting Professional Modifier None Typical Low $281.84 Median $302.00 Typical High $446.68 | Professional | None | $281.84 | $302.00 | $446.68 |
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 $223.87 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $223.87 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $89.13 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $67.61 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $44.67 | $57.54 | $57.54 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $501.19 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $446.68 | $501.19 | $524.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $223.87 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $223.87 | $288.40 | $288.40 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $89.13 | $114.82 | $114.82 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $67.61 | $87.10 | $87.10 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $44.67 | $57.54 | $57.54 |
Where Idaho sits
The same service costs 2.2 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
$575
MT $692DE $309
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.