How much rates vary
Facilitymedian $537 · 10th to 90th $316 to $912Professionalmedian $479 · 10th to 90th $229 to $708
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 $331.13 Median $478.63 Typical High $478.63 | Professional | None | $331.13 | $478.63 | $478.63 |
BCBS Idaho Setting Facility Modifier None Typical Low $436.52 Median $537.03 Typical High $912.01 | Facility | None | $436.52 | $537.03 | $912.01 |
BCBS Idaho Setting Professional Modifier None Typical Low $398.11 Median $588.84 Typical High $616.60 | Professional | None | $398.11 | $588.84 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $346.74 | Facility | None | $316.23 | $316.23 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $316.23 | Professional | None | $229.09 | $229.09 | $316.23 |
Moda Health Setting Facility Modifier None Typical Low $162.18 Median $478.63 Typical High $562.34 | Facility | None | $162.18 | $478.63 | $562.34 |
Moda Health Setting Professional Modifier None Typical Low $371.54 Median $478.63 Typical High $588.84 | Professional | None | $371.54 | $478.63 | $588.84 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $416.87 Typical High $489.78 | Professional | None | $30.20 | $416.87 | $489.78 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $446.68 Median $707.95 Typical High $33,884.42 | Facility | None | $446.68 | $707.95 | $33,884.42 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $39,810.72 | Professional | None | $562.34 | $707.95 | $39,810.72 |
Regence BlueShield Setting Facility Modifier None Typical Low $524.81 Median $537.03 Typical High $812.83 | Facility | None | $524.81 | $537.03 | $812.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $588.84 | Professional | None | $398.11 | $398.11 | $588.84 |
Select Health Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $724.44 | Facility | None | $562.34 | $562.34 | $724.44 |
Select Health Setting Professional Modifier None Typical Low $363.08 Median $562.34 Typical High $616.60 | Professional | None | $363.08 | $562.34 | $616.60 |
United Setting Professional Modifier None Typical Low $234.42 Median $251.19 Typical High $371.54 | Professional | None | $234.42 | $251.19 | $371.54 |
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 $186.21 Median $239.88 Typical High $239.88 | Professional | 52 · Reduced service | $186.21 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $95.50 Typical High $95.50 | Professional | 53 · Discontinued | $74.13 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $72.44 Typical High $72.44 | Professional | 55 · Aftercare only | $56.23 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $47.86 Typical High $47.86 | Professional | 56 · Pre-op care only | $37.15 | $47.86 | $47.86 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $416.87 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $371.54 | $416.87 | $436.52 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $186.21 Median $239.88 Typical High $239.88 | Professional | 52 · Reduced service | $186.21 | $239.88 | $239.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $95.50 Typical High $95.50 | Professional | 53 · Discontinued | $74.13 | $95.50 | $95.50 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $72.44 Typical High $72.44 | Professional | 55 · Aftercare only | $56.23 | $72.44 | $72.44 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $47.86 Typical High $47.86 | Professional | 56 · Pre-op care only | $37.15 | $47.86 | $47.86 |
Where Idaho sits
The same service costs 2.6 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
$479
MT $589DE $229
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.