How much rates vary
Facilitymedian $219 · 10th to 90th $141 to $372Professionalmedian $200 · 10th to 90th $102 to $288
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 $151.36 Median $199.53 Typical High $199.53 | Professional | None | $151.36 | $199.53 | $199.53 |
BCBS Idaho Setting Facility Modifier None Typical Low $165.96 Median $218.78 Typical High $363.08 | Facility | None | $165.96 | $218.78 | $363.08 |
BCBS Idaho Setting Professional Modifier None Typical Low $162.18 Median $239.88 Typical High $251.19 | Professional | None | $162.18 | $239.88 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $154.88 | Facility | None | $141.25 | $141.25 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $141.25 | Professional | None | $102.33 | $102.33 | $141.25 |
Moda Health Setting Facility Modifier None Typical Low $72.44 Median $199.53 Typical High $229.09 | Facility | None | $72.44 | $199.53 | $229.09 |
Moda Health Setting Professional Modifier None Typical Low $151.36 Median $208.93 Typical High $239.88 | Professional | None | $151.36 | $208.93 | $239.88 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $173.78 Typical High $199.53 | Professional | None | $30.20 | $173.78 | $199.53 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $186.21 Median $288.40 Typical High $13,803.84 | Facility | None | $186.21 | $288.40 | $13,803.84 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $239.88 Median $288.40 Typical High $16,218.10 | Professional | None | $239.88 | $288.40 | $16,218.10 |
Regence BlueShield Setting Facility Modifier None Typical Low $213.80 Median $218.78 Typical High $331.13 | Facility | None | $213.80 | $218.78 | $331.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $239.88 | Professional | None | $162.18 | $162.18 | $239.88 |
Select Health Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $295.12 | Facility | None | $229.09 | $229.09 | $295.12 |
Select Health Setting Professional Modifier None Typical Low $151.36 Median $229.09 Typical High $251.19 | Professional | None | $151.36 | $229.09 | $251.19 |
United Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $389.05 | Facility | None | $151.36 | $151.36 | $389.05 |
United Setting Professional Modifier None Typical Low $104.71 Median $112.20 Typical High $165.96 | Professional | None | $104.71 | $112.20 | $165.96 |
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 $75.86 Median $100.00 Typical High $100.00 | Professional | 52 · Reduced service | $75.86 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $39.81 Typical High $39.81 | Professional | 53 · Discontinued | $30.20 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $29.51 Typical High $29.51 | Professional | 55 · Aftercare only | $22.91 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $19.95 Typical High $19.95 | Professional | 56 · Pre-op care only | $15.14 | $19.95 | $19.95 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $169.82 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $151.36 | $169.82 | $177.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $75.86 Median $100.00 Typical High $100.00 | Professional | 52 · Reduced service | $75.86 | $100.00 | $100.00 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $39.81 Typical High $39.81 | Professional | 53 · Discontinued | $30.20 | $39.81 | $39.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $29.51 Typical High $29.51 | Professional | 55 · Aftercare only | $22.91 | $29.51 | $29.51 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $19.95 Typical High $19.95 | Professional | 56 · Pre-op care only | $15.14 | $19.95 | $19.95 |
Where Idaho sits
The same service costs 8.1 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· 11th of 51
$200
HI $832DE $102
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.