How much rates vary
Facilitymedian $251 · 10th to 90th $145 to $427Professionalmedian $224 · 10th to 90th $100 to $331
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 $173.78 Median $223.87 Typical High $223.87 | Professional | None | $173.78 | $223.87 | $223.87 |
BCBS Idaho Setting Facility Modifier None Typical Low $204.17 Median $251.19 Typical High $426.58 | Facility | None | $204.17 | $251.19 | $426.58 |
BCBS Idaho Setting Professional Modifier None Typical Low $181.97 Median $275.42 Typical High $288.40 | Professional | None | $181.97 | $275.42 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $151.36 | Facility | None | $144.54 | $144.54 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $144.54 | Professional | None | $104.71 | $104.71 | $144.54 |
Moda Health Setting Facility Modifier None Typical Low $64.57 Median $223.87 Typical High $263.03 | Facility | None | $64.57 | $223.87 | $263.03 |
Moda Health Setting Professional Modifier None Typical Low $173.78 Median $234.42 Typical High $275.42 | Professional | None | $173.78 | $234.42 | $275.42 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $194.98 Typical High $223.87 | Professional | None | $30.20 | $194.98 | $223.87 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $208.93 Median $331.13 Typical High $15,848.93 | Facility | None | $208.93 | $331.13 | $15,848.93 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $263.03 Median $331.13 Typical High $18,620.87 | Professional | None | $263.03 | $331.13 | $18,620.87 |
Regence BlueShield Setting Facility Modifier None Typical Low $245.47 Median $251.19 Typical High $380.19 | Facility | None | $245.47 | $251.19 | $380.19 |
Regence BlueShield Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $275.42 | Professional | None | $181.97 | $181.97 | $275.42 |
Select Health Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $338.84 | Facility | None | $263.03 | $263.03 | $338.84 |
Select Health Setting Professional Modifier None Typical Low $169.82 Median $263.03 Typical High $288.40 | Professional | None | $169.82 | $263.03 | $288.40 |
United Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $100.00 | Facility | None | $87.10 | $87.10 | $100.00 |
United Setting Professional Modifier None Typical Low $91.20 Median $100.00 Typical High $147.91 | Professional | None | $91.20 | $100.00 | $147.91 |
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 $87.10 Median $112.20 Typical High $112.20 | Professional | 52 · Reduced service | $87.10 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $44.67 Typical High $44.67 | Professional | 53 · Discontinued | $34.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $26.30 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $22.39 Typical High $22.39 | Professional | 56 · Pre-op care only | $17.38 | $22.39 | $22.39 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $194.98 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $173.78 | $194.98 | $204.17 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $87.10 Median $112.20 Typical High $112.20 | Professional | 52 · Reduced service | $87.10 | $112.20 | $112.20 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $44.67 Typical High $44.67 | Professional | 53 · Discontinued | $34.67 | $44.67 | $44.67 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $26.30 | $33.88 | $33.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $22.39 Typical High $22.39 | Professional | 56 · Pre-op care only | $17.38 | $22.39 | $22.39 |
Where Idaho sits
The same service costs 2.5 times more in Montana 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· 7th of 51
$224
MT $263FL $105
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.