How much rates vary
Facilitymedian $263 · 10th to 90th $166 to $437Professionalmedian $234 · 10th to 90th $115 to $339
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 $181.97 Median $234.42 Typical High $234.42 | Professional | None | $181.97 | $234.42 | $234.42 |
BCBS Idaho Setting Facility Modifier None Typical Low $213.80 Median $263.03 Typical High $436.52 | Facility | None | $213.80 | $263.03 | $436.52 |
BCBS Idaho Setting Professional Modifier None Typical Low $190.55 Median $288.40 Typical High $302.00 | Professional | None | $190.55 | $288.40 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $186.21 | Facility | None | $165.96 | $165.96 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $165.96 | Professional | None | $120.23 | $120.23 | $165.96 |
Moda Health Setting Facility Modifier None Typical Low $74.13 Median $234.42 Typical High $275.42 | Facility | None | $74.13 | $234.42 | $275.42 |
Moda Health Setting Professional Modifier None Typical Low $181.97 Median $234.42 Typical High $288.40 | Professional | None | $181.97 | $234.42 | $288.40 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $204.17 Typical High $234.42 | Professional | None | $30.20 | $204.17 | $234.42 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $204.17 Median $338.84 Typical High $16,218.10 | Facility | None | $204.17 | $338.84 | $16,218.10 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $275.42 Median $338.84 Typical High $19,054.61 | Professional | None | $275.42 | $338.84 | $19,054.61 |
Regence BlueShield Setting Facility Modifier None Typical Low $257.04 Median $263.03 Typical High $389.05 | Facility | None | $257.04 | $263.03 | $389.05 |
Regence BlueShield Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $288.40 | Professional | None | $190.55 | $190.55 | $288.40 |
Select Health Setting Facility Modifier None Typical Low $257.04 Median $275.42 Typical High $346.74 | Facility | None | $257.04 | $275.42 | $346.74 |
Select Health Setting Professional Modifier None Typical Low $177.83 Median $275.42 Typical High $302.00 | Professional | None | $177.83 | $275.42 | $302.00 |
United Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $213.80 | Facility | None | $154.88 | $154.88 | $213.80 |
United Setting Professional Modifier None Typical Low $107.15 Median $114.82 Typical High $169.82 | Professional | None | $107.15 | $114.82 | $169.82 |
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 $91.20 Median $117.49 Typical High $117.49 | Professional | 52 · Reduced service | $91.20 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $46.77 Typical High $46.77 | Professional | 53 · Discontinued | $36.31 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $35.48 Typical High $35.48 | Professional | 55 · Aftercare only | $26.92 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $23.44 Typical High $23.44 | Professional | 56 · Pre-op care only | $18.20 | $23.44 | $23.44 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $199.53 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $177.83 | $199.53 | $208.93 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $117.49 Typical High $117.49 | Professional | 52 · Reduced service | $91.20 | $117.49 | $117.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $46.77 Typical High $46.77 | Professional | 53 · Discontinued | $36.31 | $46.77 | $46.77 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $35.48 Typical High $35.48 | Professional | 55 · Aftercare only | $26.92 | $35.48 | $35.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $23.44 Typical High $23.44 | Professional | 56 · Pre-op care only | $18.20 | $23.44 | $23.44 |
Where Idaho sits
The same service costs 4.4 times more in Hawaii than in Florida. 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· 10th of 51
$234
HI $525FL $120
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.