How much rates vary
Facilitymedian $1,023 · 10th to 90th $708 to $1,698Professionalmedian $912 · 10th to 90th $479 to $1,349
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 $707.95 Median $912.01 Typical High $912.01 | Professional | None | $707.95 | $912.01 | $912.01 |
BCBS Idaho Setting Facility Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,698.24 | Facility | None | $758.58 | $1,023.29 | $1,698.24 |
BCBS Idaho Setting Professional Modifier None Typical Low $741.31 Median $1,122.02 Typical High $1,174.90 | Professional | None | $741.31 | $1,122.02 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $776.25 | Facility | None | $724.44 | $724.44 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $724.44 | Professional | None | $537.03 | $537.03 | $724.44 |
Moda Health Setting Facility Modifier None Typical Low $309.03 Median $912.01 Typical High $1,071.52 | Facility | None | $309.03 | $912.01 | $1,071.52 |
Moda Health Setting Professional Modifier None Typical Low $707.95 Median $912.01 Typical High $1,122.02 | Professional | None | $707.95 | $912.01 | $1,122.02 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $794.33 Typical High $912.01 | Professional | None | $30.20 | $794.33 | $912.01 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $851.14 Median $1,348.96 Typical High $64,565.42 | Facility | None | $851.14 | $1,348.96 | $64,565.42 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,071.52 Median $1,348.96 Typical High $75,857.76 | Professional | None | $1,071.52 | $1,348.96 | $75,857.76 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,000.00 Median $1,023.29 Typical High $1,548.82 | Facility | None | $1,000.00 | $1,023.29 | $1,548.82 |
Regence BlueShield Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,122.02 | Professional | None | $741.31 | $741.31 | $1,122.02 |
Select Health Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,380.38 | Facility | None | $1,071.52 | $1,071.52 | $1,380.38 |
Select Health Setting Professional Modifier None Typical Low $691.83 Median $1,071.52 Typical High $1,174.90 | Professional | None | $691.83 | $1,071.52 | $1,174.90 |
United Setting Professional Modifier None Typical Low $446.68 Median $478.63 Typical High $707.95 | Professional | None | $446.68 | $478.63 | $707.95 |
5 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 55 · Aftercare only Typical Low $107.15 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $107.15 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $70.79 | $91.20 | $91.20 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $794.33 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $707.95 | $794.33 | $831.76 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $107.15 | $138.04 | $138.04 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $70.79 | $91.20 | $91.20 |
Where Idaho sits
The same service costs 2.0 times more in Montana than in West Virginia. 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
$912
MT $1,096WV $537
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.