How much rates vary
Facilitymedian $447 · 10th to 90th $234 to $741Professionalmedian $398 · 10th to 90th $174 to $589
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 $309.03 Median $398.11 Typical High $398.11 | Professional | None | $309.03 | $398.11 | $398.11 |
BCBS Idaho Setting Facility Modifier None Typical Low $354.81 Median $446.68 Typical High $741.31 | Facility | None | $354.81 | $446.68 | $741.31 |
BCBS Idaho Setting Professional Modifier None Typical Low $331.13 Median $489.78 Typical High $512.86 | Professional | None | $331.13 | $489.78 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $251.19 | Facility | None | $234.42 | $234.42 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $234.42 | Professional | None | $173.78 | $173.78 | $234.42 |
Moda Health Setting Facility Modifier None Typical Low $123.03 Median $398.11 Typical High $467.74 | Facility | None | $123.03 | $398.11 | $467.74 |
Moda Health Setting Professional Modifier None Typical Low $309.03 Median $416.87 Typical High $489.78 | Professional | None | $309.03 | $416.87 | $489.78 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $354.81 Typical High $407.38 | Professional | None | $30.20 | $354.81 | $407.38 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $302.00 Median $588.84 Typical High $28,183.83 | Facility | None | $302.00 | $588.84 | $28,183.83 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $33,113.11 | Professional | None | $467.74 | $588.84 | $33,113.11 |
Regence BlueShield Setting Facility Modifier None Typical Low $436.52 Median $446.68 Typical High $676.08 | Facility | None | $436.52 | $446.68 | $676.08 |
Regence BlueShield Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $489.78 | Professional | None | $331.13 | $331.13 | $489.78 |
Select Health Setting Facility Modifier None Typical Low $436.52 Median $467.74 Typical High $602.56 | Facility | None | $436.52 | $467.74 | $602.56 |
Select Health Setting Professional Modifier None Typical Low $302.00 Median $467.74 Typical High $501.19 | Professional | None | $302.00 | $467.74 | $501.19 |
United Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $380.19 | Facility | None | $251.19 | $251.19 | $380.19 |
United Setting Professional Modifier None Typical Low $173.78 Median $190.55 Typical High $281.84 | Professional | None | $173.78 | $190.55 | $281.84 |
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 $154.88 Median $199.53 Typical High $199.53 | Professional | 52 · Reduced service | $154.88 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $61.66 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $60.26 Typical High $60.26 | Professional | 55 · Aftercare only | $46.77 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $30.90 | $39.81 | $39.81 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $346.74 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $309.03 | $346.74 | $363.08 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $154.88 Median $199.53 Typical High $199.53 | Professional | 52 · Reduced service | $154.88 | $199.53 | $199.53 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $61.66 | $81.28 | $81.28 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $60.26 Typical High $60.26 | Professional | 55 · Aftercare only | $46.77 | $60.26 | $60.26 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $30.90 | $39.81 | $39.81 |
Where Idaho sits
The same service costs 5.5 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· 4th of 51
$398
HI $955FL $174
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.