How much rates vary
Facilitymedian $759 · 10th to 90th $407 to $1,288Professionalmedian $676 · 10th to 90th $295 to $977
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 $524.81 Median $676.08 Typical High $676.08 | Professional | None | $524.81 | $676.08 | $676.08 |
BCBS Idaho Setting Facility Modifier None Typical Low $616.60 Median $758.58 Typical High $1,288.25 | Facility | None | $616.60 | $758.58 | $1,288.25 |
BCBS Idaho Setting Professional Modifier None Typical Low $549.54 Median $831.76 Typical High $870.96 | Professional | None | $549.54 | $831.76 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $436.52 | Facility | None | $407.38 | $407.38 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $407.38 | Professional | None | $295.12 | $295.12 | $407.38 |
Moda Health Setting Facility Modifier None Typical Low $208.93 Median $676.08 Typical High $794.33 | Facility | None | $208.93 | $676.08 | $794.33 |
Moda Health Setting Professional Modifier None Typical Low $524.81 Median $707.95 Typical High $831.76 | Professional | None | $524.81 | $707.95 | $831.76 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $588.84 Typical High $676.08 | Professional | None | $30.20 | $588.84 | $676.08 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $537.03 Median $977.24 Typical High $46,773.51 | Facility | None | $537.03 | $977.24 | $46,773.51 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $794.33 Median $977.24 Typical High $54,954.09 | Professional | None | $794.33 | $977.24 | $54,954.09 |
Regence BlueShield Setting Facility Modifier None Typical Low $741.31 Median $758.58 Typical High $1,122.02 | Facility | None | $741.31 | $758.58 | $1,122.02 |
Regence BlueShield Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $831.76 | Professional | None | $549.54 | $549.54 | $831.76 |
Select Health Setting Facility Modifier None Typical Low $724.44 Median $794.33 Typical High $1,000.00 | Facility | None | $724.44 | $794.33 | $1,000.00 |
Select Health Setting Professional Modifier None Typical Low $512.86 Median $794.33 Typical High $851.14 | Professional | None | $512.86 | $794.33 | $851.14 |
United Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $575.44 | Facility | None | $436.52 | $436.52 | $575.44 |
United Setting Professional Modifier None Typical Low $302.00 Median $323.59 Typical High $489.78 | Professional | None | $302.00 | $323.59 | $489.78 |
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 $263.03 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $263.03 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $104.71 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $77.62 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $52.48 | $67.61 | $67.61 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $575.44 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $512.86 | $575.44 | $602.56 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $263.03 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $263.03 | $338.84 | $338.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $104.71 | $134.90 | $134.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $77.62 | $102.33 | $102.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $52.48 | $67.61 | $67.61 |
Where Idaho sits
The same service costs 4.3 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· 6th of 51
$676
HI $1,259DE $295
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.