How much rates vary
Facilitymedian $182 · 10th to 90th $129 to $309Professionalmedian $166 · 10th to 90th $87 to $240
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 $128.82 Median $165.96 Typical High $165.96 | Professional | None | $128.82 | $165.96 | $165.96 |
BCBS Idaho Setting Facility Modifier None Typical Low $138.04 Median $186.21 Typical High $309.03 | Facility | None | $138.04 | $186.21 | $309.03 |
BCBS Idaho Setting Professional Modifier None Typical Low $134.90 Median $204.17 Typical High $213.80 | Professional | None | $134.90 | $204.17 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $134.90 | Facility | None | $128.82 | $128.82 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $128.82 | Professional | None | $95.50 | $95.50 | $128.82 |
Moda Health Setting Facility Modifier None Typical Low $56.23 Median $165.96 Typical High $194.98 | Facility | None | $56.23 | $165.96 | $194.98 |
Moda Health Setting Professional Modifier None Typical Low $128.82 Median $173.78 Typical High $204.17 | Professional | None | $128.82 | $173.78 | $204.17 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $144.54 Typical High $165.96 | Professional | None | $30.20 | $144.54 | $165.96 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $154.88 Median $239.88 Typical High $11,748.98 | Facility | None | $154.88 | $239.88 | $11,748.98 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $194.98 Median $239.88 Typical High $13,489.63 | Professional | None | $194.98 | $239.88 | $13,489.63 |
Regence BlueShield Setting Facility Modifier None Typical Low $181.97 Median $186.21 Typical High $275.42 | Facility | None | $181.97 | $186.21 | $275.42 |
Regence BlueShield Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $204.17 | Professional | None | $134.90 | $134.90 | $204.17 |
Select Health Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $251.19 | Facility | None | $194.98 | $194.98 | $251.19 |
Select Health Setting Professional Modifier None Typical Low $125.89 Median $194.98 Typical High $213.80 | Professional | None | $125.89 | $194.98 | $213.80 |
United Setting Professional Modifier None Typical Low $79.43 Median $87.10 Typical High $128.82 | Professional | None | $79.43 | $87.10 | $128.82 |
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 $64.57 Median $83.18 Typical High $83.18 | Professional | 52 · Reduced service | $64.57 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $33.11 Typical High $33.11 | Professional | 53 · Discontinued | $25.70 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $25.12 Typical High $25.12 | Professional | 55 · Aftercare only | $19.05 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $16.60 Typical High $16.60 | Professional | 56 · Pre-op care only | $12.88 | $16.60 | $16.60 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $141.25 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $125.89 | $141.25 | $147.91 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $64.57 Median $83.18 Typical High $83.18 | Professional | 52 · Reduced service | $64.57 | $83.18 | $83.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $33.11 Typical High $33.11 | Professional | 53 · Discontinued | $25.70 | $33.11 | $33.11 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $25.12 Typical High $25.12 | Professional | 55 · Aftercare only | $19.05 | $25.12 | $25.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $16.60 Typical High $16.60 | Professional | 56 · Pre-op care only | $12.88 | $16.60 | $16.60 |
Where Idaho sits
The same service costs 2.5 times more in Kansas than in Utah. 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
$166
KS $234UT $95.50
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.