How much rates vary
Facilitymedian $275 · 10th to 90th $158 to $457Professionalmedian $245 · 10th to 90th $117 to $355
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 $190.55 Median $245.47 Typical High $245.47 | Professional | None | $190.55 | $245.47 | $245.47 |
BCBS Idaho Setting Facility Modifier None Typical Low $223.87 Median $275.42 Typical High $457.09 | Facility | None | $223.87 | $275.42 | $457.09 |
BCBS Idaho Setting Professional Modifier None Typical Low $199.53 Median $302.00 Typical High $316.23 | Professional | None | $199.53 | $302.00 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $169.82 | Facility | None | $158.49 | $158.49 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $158.49 | Professional | None | $117.49 | $117.49 | $158.49 |
Moda Health Setting Facility Modifier None Typical Low $83.18 Median $245.47 Typical High $288.40 | Facility | None | $83.18 | $245.47 | $288.40 |
Moda Health Setting Professional Modifier None Typical Low $190.55 Median $257.04 Typical High $302.00 | Professional | None | $190.55 | $257.04 | $302.00 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $213.80 Typical High $245.47 | Professional | None | $30.20 | $213.80 | $245.47 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $218.78 Median $354.81 Typical High $16,982.44 | Facility | None | $218.78 | $354.81 | $16,982.44 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $288.40 Median $354.81 Typical High $19,952.62 | Professional | None | $288.40 | $354.81 | $19,952.62 |
Regence BlueShield Setting Facility Modifier None Typical Low $269.15 Median $275.42 Typical High $407.38 | Facility | None | $269.15 | $275.42 | $407.38 |
Regence BlueShield Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $302.00 | Professional | None | $199.53 | $199.53 | $302.00 |
Select Health Setting Facility Modifier None Typical Low $275.42 Median $288.40 Typical High $363.08 | Facility | None | $275.42 | $288.40 | $363.08 |
Select Health Setting Professional Modifier None Typical Low $186.21 Median $288.40 Typical High $316.23 | Professional | None | $186.21 | $288.40 | $316.23 |
United Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $169.82 | Facility | None | $141.25 | $141.25 | $169.82 |
United Setting Professional Modifier None Typical Low $117.49 Median $128.82 Typical High $190.55 | Professional | None | $117.49 | $128.82 | $190.55 |
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 $95.50 Median $123.03 Typical High $123.03 | Professional | 52 · Reduced service | $95.50 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $48.98 Typical High $48.98 | Professional | 53 · Discontinued | $38.02 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $37.15 Typical High $37.15 | Professional | 55 · Aftercare only | $28.18 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $24.55 Typical High $24.55 | Professional | 56 · Pre-op care only | $19.05 | $24.55 | $24.55 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $208.93 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $186.21 | $208.93 | $218.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $123.03 Typical High $123.03 | Professional | 52 · Reduced service | $95.50 | $123.03 | $123.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $48.98 Typical High $48.98 | Professional | 53 · Discontinued | $38.02 | $48.98 | $48.98 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $37.15 Typical High $37.15 | Professional | 55 · Aftercare only | $28.18 | $37.15 | $37.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $24.55 Typical High $24.55 | Professional | 56 · Pre-op care only | $19.05 | $24.55 | $24.55 |
Where Idaho sits
The same service costs 4.4 times more in Hawaii than in Kansas. 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· 12th of 51
$245
HI $468KS $107
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.