How much rates vary
Facilitymedian $776 · 10th to 90th $501 to $1,288Professionalmedian $708 · 10th to 90th $363 to $1,023
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 $537.03 Median $707.95 Typical High $707.95 | Professional | None | $537.03 | $707.95 | $707.95 |
BCBS Idaho Setting Facility Modifier None Typical Low $630.96 Median $776.25 Typical High $1,288.25 | Facility | None | $630.96 | $776.25 | $1,288.25 |
BCBS Idaho Setting Professional Modifier None Typical Low $575.44 Median $851.14 Typical High $891.25 | Professional | None | $575.44 | $851.14 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $549.54 | Facility | None | $501.19 | $501.19 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $501.19 | Professional | None | $363.08 | $363.08 | $501.19 |
Moda Health Setting Facility Modifier None Typical Low $257.04 Median $707.95 Typical High $812.83 | Facility | None | $257.04 | $707.95 | $812.83 |
Moda Health Setting Professional Modifier None Typical Low $537.03 Median $741.31 Typical High $851.14 | Professional | None | $537.03 | $741.31 | $851.14 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $616.60 Typical High $707.95 | Professional | None | $30.20 | $616.60 | $707.95 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $645.65 Median $1,023.29 Typical High $48,977.88 | Facility | None | $645.65 | $1,023.29 | $48,977.88 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $57,543.99 | Professional | None | $812.83 | $1,023.29 | $57,543.99 |
Regence BlueShield Setting Facility Modifier None Typical Low $758.58 Median $776.25 Typical High $1,174.90 | Facility | None | $758.58 | $776.25 | $1,174.90 |
Regence BlueShield Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $851.14 | Professional | None | $575.44 | $575.44 | $851.14 |
Select Health Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $1,047.13 | Facility | None | $812.83 | $812.83 | $1,047.13 |
Select Health Setting Professional Modifier None Typical Low $537.03 Median $812.83 Typical High $891.25 | Professional | None | $537.03 | $812.83 | $891.25 |
United Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $562.34 | Facility | None | $537.03 | $537.03 | $562.34 |
United Setting Professional Modifier None Typical Low $371.54 Median $398.11 Typical High $588.84 | Professional | None | $371.54 | $398.11 | $588.84 |
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 $269.15 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $269.15 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $107.15 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $81.28 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $53.70 | $70.79 | $70.79 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $602.56 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $537.03 | $602.56 | $630.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $269.15 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $269.15 | $354.81 | $354.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $107.15 | $141.25 | $141.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $81.28 | $104.71 | $104.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $53.70 | $70.79 | $70.79 |
Where Idaho sits
The same service costs 3.9 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
$708
HI $1,413DE $363
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.