How much rates vary
Facilitymedian $603 · 10th to 90th $372 to $1,000Professionalmedian $537 · 10th to 90th $263 to $794
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 $416.87 Median $537.03 Typical High $537.03 | Professional | None | $416.87 | $537.03 | $537.03 |
BCBS Idaho Setting Facility Modifier None Typical Low $489.78 Median $602.56 Typical High $1,000.00 | Facility | None | $489.78 | $602.56 | $1,000.00 |
BCBS Idaho Setting Professional Modifier None Typical Low $436.52 Median $660.69 Typical High $691.83 | Professional | None | $436.52 | $660.69 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $398.11 | Facility | None | $371.54 | $371.54 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $371.54 | Professional | None | $275.42 | $275.42 | $371.54 |
Moda Health Setting Facility Modifier None Typical Low $169.82 Median $537.03 Typical High $630.96 | Facility | None | $169.82 | $537.03 | $630.96 |
Moda Health Setting Professional Modifier None Typical Low $416.87 Median $562.34 Typical High $660.69 | Professional | None | $416.87 | $562.34 | $660.69 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $467.74 Typical High $537.03 | Professional | None | $30.20 | $467.74 | $537.03 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $501.19 Median $794.33 Typical High $38,018.94 | Facility | None | $501.19 | $794.33 | $38,018.94 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $44,668.36 | Professional | None | $630.96 | $794.33 | $44,668.36 |
Regence BlueShield Setting Facility Modifier None Typical Low $588.84 Median $602.56 Typical High $912.01 | Facility | None | $588.84 | $602.56 | $912.01 |
Regence BlueShield Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $660.69 | Professional | None | $436.52 | $436.52 | $660.69 |
Select Health Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $812.83 | Facility | None | $630.96 | $630.96 | $812.83 |
Select Health Setting Professional Modifier None Typical Low $407.38 Median $630.96 Typical High $691.83 | Professional | None | $407.38 | $630.96 | $691.83 |
United Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
United Setting Professional Modifier None Typical Low $239.88 Median $263.03 Typical High $389.05 | Professional | None | $239.88 | $263.03 | $389.05 |
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 $208.93 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $208.93 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $83.18 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $63.10 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $41.69 | $53.70 | $53.70 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $467.74 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $416.87 | $467.74 | $489.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $208.93 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $208.93 | $269.15 | $269.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $83.18 | $107.15 | $107.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $63.10 | $81.28 | $81.28 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $41.69 | $53.70 | $53.70 |
Where Idaho sits
The same service costs 4.5 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· 8th of 51
$537
HI $912KS $204
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.