How much rates vary
Facilitymedian $631 · 10th to 90th $363 to $1,072Professionalmedian $575 · 10th to 90th $245 to $832
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 $446.68 Median $575.44 Typical High $575.44 | Professional | None | $446.68 | $575.44 | $575.44 |
BCBS Idaho Setting Facility Modifier None Typical Low $478.63 Median $645.65 Typical High $1,071.52 | Facility | None | $478.63 | $645.65 | $1,071.52 |
BCBS Idaho Setting Professional Modifier None Typical Low $467.74 Median $707.95 Typical High $741.31 | Professional | None | $467.74 | $707.95 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $416.87 | Facility | None | $389.05 | $389.05 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $389.05 | Professional | None | $281.84 | $281.84 | $389.05 |
Moda Health Setting Facility Modifier None Typical Low $158.49 Median $575.44 Typical High $676.08 | Facility | None | $158.49 | $575.44 | $676.08 |
Moda Health Setting Professional Modifier None Typical Low $446.68 Median $602.56 Typical High $707.95 | Professional | None | $446.68 | $602.56 | $707.95 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $501.19 Typical High $575.44 | Professional | None | $30.20 | $501.19 | $575.44 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $446.68 Median $831.76 Typical High $40,738.03 | Facility | None | $446.68 | $831.76 | $40,738.03 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $676.08 Median $831.76 Typical High $46,773.51 | Professional | None | $676.08 | $831.76 | $46,773.51 |
Regence BlueShield Setting Facility Modifier None Typical Low $630.96 Median $645.65 Typical High $954.99 | Facility | None | $630.96 | $645.65 | $954.99 |
Regence BlueShield Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $707.95 | Professional | None | $467.74 | $467.74 | $707.95 |
Select Health Setting Facility Modifier None Typical Low $616.60 Median $676.08 Typical High $870.96 | Facility | None | $616.60 | $676.08 | $870.96 |
Select Health Setting Professional Modifier None Typical Low $436.52 Median $676.08 Typical High $724.44 | Professional | None | $436.52 | $676.08 | $724.44 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $426.58 | Facility | None | $331.13 | $331.13 | $426.58 |
United Setting Professional Modifier None Typical Low $229.09 Median $245.47 Typical High $363.08 | Professional | None | $229.09 | $245.47 | $363.08 |
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 $223.87 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $223.87 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $89.13 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $66.07 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $44.67 | $57.54 | $57.54 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $489.78 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $436.52 | $489.78 | $512.86 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $223.87 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $223.87 | $288.40 | $288.40 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $89.13 | $114.82 | $114.82 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $66.07 | $87.10 | $87.10 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $44.67 | $57.54 | $57.54 |
Where Idaho sits
The same service costs 3.4 times more in Hawaii than in Washington, DC. 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· 3rd of 51
$575
HI $891DC $263
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.