How much rates vary
Facilitymedian $537 · 10th to 90th $339 to $871Professionalmedian $479 · 10th to 90th $245 to $692
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 $371.54 Median $478.63 Typical High $478.63 | Professional | None | $371.54 | $478.63 | $478.63 |
BCBS Idaho Setting Facility Modifier None Typical Low $398.11 Median $537.03 Typical High $870.96 | Facility | None | $398.11 | $537.03 | $870.96 |
BCBS Idaho Setting Professional Modifier None Typical Low $389.05 Median $588.84 Typical High $616.60 | Professional | None | $389.05 | $588.84 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $363.08 | Facility | None | $338.84 | $338.84 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $338.84 | Professional | None | $245.47 | $245.47 | $338.84 |
Moda Health Setting Facility Modifier None Typical Low $173.78 Median $478.63 Typical High $549.54 | Facility | None | $173.78 | $478.63 | $549.54 |
Moda Health Setting Professional Modifier None Typical Low $371.54 Median $501.19 Typical High $588.84 | Professional | None | $371.54 | $501.19 | $588.84 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $416.87 Typical High $478.63 | Professional | None | $30.20 | $416.87 | $478.63 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $446.68 Median $691.83 Typical High $33,113.11 | Facility | None | $446.68 | $691.83 | $33,113.11 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $38,904.51 | Professional | None | $549.54 | $691.83 | $38,904.51 |
Regence BlueShield Setting Facility Modifier None Typical Low $512.86 Median $537.03 Typical High $794.33 | Facility | None | $512.86 | $537.03 | $794.33 |
Regence BlueShield Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $588.84 | Professional | None | $389.05 | $389.05 | $588.84 |
Select Health Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $707.95 | Facility | None | $549.54 | $549.54 | $707.95 |
Select Health Setting Professional Modifier None Typical Low $363.08 Median $549.54 Typical High $602.56 | Professional | None | $363.08 | $549.54 | $602.56 |
United Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $407.38 | Facility | None | $354.81 | $354.81 | $407.38 |
United Setting Professional Modifier None Typical Low $245.47 Median $269.15 Typical High $398.11 | Professional | None | $245.47 | $269.15 | $398.11 |
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 $181.97 Median $239.88 Typical High $239.88 | Professional | 52 · Reduced service | $181.97 | $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 $54.95 Median $70.79 Typical High $70.79 | Professional | 55 · Aftercare only | $54.95 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $47.86 Typical High $47.86 | Professional | 56 · Pre-op care only | $36.31 | $47.86 | $47.86 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $407.38 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $363.08 | $407.38 | $426.58 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $181.97 Median $239.88 Typical High $239.88 | Professional | 52 · Reduced service | $181.97 | $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 $54.95 Median $70.79 Typical High $70.79 | Professional | 55 · Aftercare only | $54.95 | $70.79 | $70.79 |
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 4.2 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· 14th of 51
$479
HI $1,023DE $245
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.