How much rates vary
Facilitymedian $302 · 10th to 90th $178 to $513Professionalmedian $275 · 10th to 90th $129 to $398
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 $275.42 Typical High $275.42 | Professional | None | $177.83 | $275.42 | $275.42 |
BCBS Idaho Setting Facility Modifier None Typical Low $245.47 Median $302.00 Typical High $512.86 | Facility | None | $245.47 | $302.00 | $512.86 |
BCBS Idaho Setting Professional Modifier None Typical Low $223.87 Median $331.13 Typical High $346.74 | Professional | None | $223.87 | $331.13 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $194.98 | Facility | None | $177.83 | $177.83 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $177.83 | Professional | None | $128.82 | $128.82 | $177.83 |
Moda Health Setting Facility Modifier None Typical Low $85.11 Median $275.42 Typical High $316.23 | Facility | None | $85.11 | $275.42 | $316.23 |
Moda Health Setting Professional Modifier None Typical Low $208.93 Median $275.42 Typical High $331.13 | Professional | None | $208.93 | $275.42 | $331.13 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $239.88 Typical High $275.42 | Professional | None | $30.20 | $239.88 | $275.42 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $234.42 Median $398.11 Typical High $19,054.61 | Facility | None | $234.42 | $398.11 | $19,054.61 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $316.23 Median $398.11 Typical High $22,387.21 | Professional | None | $316.23 | $398.11 | $22,387.21 |
Regence BlueShield Setting Facility Modifier None Typical Low $295.12 Median $302.00 Typical High $457.09 | Facility | None | $295.12 | $302.00 | $457.09 |
Regence BlueShield Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $331.13 | Professional | None | $223.87 | $223.87 | $331.13 |
Select Health Setting Facility Modifier None Typical Low $295.12 Median $316.23 Typical High $407.38 | Facility | None | $295.12 | $316.23 | $407.38 |
Select Health Setting Professional Modifier None Typical Low $204.17 Median $316.23 Typical High $346.74 | Professional | None | $204.17 | $316.23 | $346.74 |
United Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $186.21 | Facility | None | $177.83 | $177.83 | $186.21 |
United Setting Professional Modifier None Typical Low $123.03 Median $131.83 Typical High $199.53 | Professional | None | $123.03 | $131.83 | $199.53 |
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 $104.71 Median $134.90 Typical High $134.90 | Professional | 52 · Reduced service | $104.71 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $54.95 Typical High $54.95 | Professional | 53 · Discontinued | $41.69 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $31.62 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $27.54 Typical High $27.54 | Professional | 56 · Pre-op care only | $20.89 | $27.54 | $27.54 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $234.42 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $208.93 | $234.42 | $245.47 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $104.71 Median $134.90 Typical High $134.90 | Professional | 52 · Reduced service | $104.71 | $134.90 | $134.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $54.95 Typical High $54.95 | Professional | 53 · Discontinued | $41.69 | $54.95 | $54.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $31.62 | $40.74 | $40.74 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $27.54 Typical High $27.54 | Professional | 56 · Pre-op care only | $20.89 | $27.54 | $27.54 |
Where Idaho sits
The same service costs 3.5 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
$275
HI $457DE $129
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.