How much rates vary
Facilitymedian $832 · 10th to 90th $447 to $1,380Professionalmedian $759 · 10th to 90th $331 to $1,096
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 $575.44 Median $758.58 Typical High $758.58 | Professional | None | $575.44 | $758.58 | $758.58 |
BCBS Idaho Setting Facility Modifier None Typical Low $707.95 Median $831.76 Typical High $1,380.38 | Facility | None | $707.95 | $831.76 | $1,380.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $616.60 Median $912.01 Typical High $977.24 | Professional | None | $616.60 | $912.01 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $501.19 | Facility | None | $446.68 | $446.68 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $446.68 | Professional | None | $331.13 | $331.13 | $446.68 |
Moda Health Setting Facility Modifier None Typical Low $234.42 Median $758.58 Typical High $870.96 | Facility | None | $234.42 | $758.58 | $870.96 |
Moda Health Setting Professional Modifier None Typical Low $575.44 Median $794.33 Typical High $912.01 | Professional | None | $575.44 | $794.33 | $912.01 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $630.96 Typical High $741.31 | Professional | None | $30.20 | $630.96 | $741.31 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $575.44 Median $1,096.48 Typical High $52,480.75 | Facility | None | $575.44 | $1,096.48 | $52,480.75 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $870.96 Median $1,096.48 Typical High $61,659.50 | Professional | None | $870.96 | $1,096.48 | $61,659.50 |
Regence BlueShield Setting Facility Modifier None Typical Low $812.83 Median $831.76 Typical High $1,258.93 | Facility | None | $812.83 | $831.76 | $1,258.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $912.01 | Professional | None | $616.60 | $616.60 | $912.01 |
Select Health Setting Facility Modifier None Typical Low $812.83 Median $870.96 Typical High $1,122.02 | Facility | None | $812.83 | $870.96 | $1,122.02 |
Select Health Setting Professional Modifier None Typical Low $575.44 Median $870.96 Typical High $954.99 | Professional | None | $575.44 | $870.96 | $954.99 |
United Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $630.96 | Facility | None | $478.63 | $478.63 | $630.96 |
United Setting Professional Modifier None Typical Low $331.13 Median $363.08 Typical High $537.03 | Professional | None | $331.13 | $363.08 | $537.03 |
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 $288.40 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $288.40 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $117.49 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $87.10 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $57.54 | $75.86 | $75.86 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $645.65 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $575.44 | $645.65 | $676.08 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $288.40 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $288.40 | $380.19 | $380.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $117.49 | $151.36 | $151.36 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $87.10 | $112.20 | $112.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $57.54 | $75.86 | $75.86 |
Where Idaho sits
The same service costs 4.6 times more in Hawaii than in Delaware. 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· 5th of 51
$759
HI $1,514DE $331
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.