How much rates vary
Facilitymedian $263 · 10th to 90th $141 to $437Professionalmedian $234 · 10th to 90th $105 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 Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Facility | None | $354.81 | $354.81 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $234.42 Typical High $269.15 | Professional | None | $162.18 | $234.42 | $269.15 |
BCBS Idaho Setting Facility Modifier None Typical Low $229.09 Median $263.03 Typical High $436.52 | Facility | None | $229.09 | $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 $141.25 Median $141.25 Typical High $147.91 | Facility | None | $141.25 | $141.25 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $141.25 | Professional | None | $104.71 | $104.71 | $141.25 |
Moda Health Setting Facility Modifier None Typical Low $177.83 Median $234.42 Typical High $275.42 | Facility | None | $177.83 | $234.42 | $275.42 |
Moda Health Setting Professional Modifier None Typical Low $181.97 Median $245.47 Typical High $288.40 | Professional | None | $181.97 | $245.47 | $288.40 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $194.98 Typical High $229.09 | Professional | None | $30.20 | $194.98 | $229.09 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $275.42 Median $338.84 Typical High $16,218.10 | Facility | None | $275.42 | $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 $275.42 Median $275.42 Typical High $281.84 | Facility | None | $275.42 | $275.42 | $281.84 |
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 Professional Modifier None Typical Low $114.82 Median $123.03 Typical High $151.36 | Professional | None | $114.82 | $123.03 | $151.36 |
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 2.2 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· 11th of 51
$234
HI $275DE $126
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.