How much rates vary
Facilitymedian $331 · 10th to 90th $229 to $575Professionalmedian $295 · 10th to 90th $166 to $437
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 $218.78 Median $295.12 Typical High $295.12 | Professional | None | $218.78 | $295.12 | $295.12 |
BCBS Idaho Setting Facility Modifier None Typical Low $269.15 Median $331.13 Typical High $562.34 | Facility | None | $269.15 | $331.13 | $562.34 |
BCBS Idaho Setting Professional Modifier None Typical Low $245.47 Median $363.08 Typical High $380.19 | Professional | None | $245.47 | $363.08 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $257.04 | Facility | None | $229.09 | $229.09 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $229.09 | Professional | None | $165.96 | $165.96 | $229.09 |
Moda Health Setting Facility Modifier None Typical Low $109.65 Median $295.12 Typical High $346.74 | Facility | None | $109.65 | $295.12 | $346.74 |
Moda Health Setting Professional Modifier None Typical Low $229.09 Median $331.13 Typical High $363.08 | Professional | None | $229.09 | $331.13 | $363.08 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $251.19 Typical High $295.12 | Professional | None | $30.20 | $251.19 | $295.12 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $275.42 Median $436.52 Typical High $20,892.96 | Facility | None | $275.42 | $436.52 | $20,892.96 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $346.74 Median $436.52 Typical High $24,547.09 | Professional | None | $346.74 | $436.52 | $24,547.09 |
Regence BlueShield Setting Facility Modifier None Typical Low $323.59 Median $331.13 Typical High $501.19 | Facility | None | $323.59 | $331.13 | $501.19 |
Regence BlueShield Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $363.08 | Professional | None | $245.47 | $245.47 | $363.08 |
Select Health Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $446.68 | Facility | None | $346.74 | $346.74 | $446.68 |
Select Health Setting Professional Modifier None Typical Low $223.87 Median $346.74 Typical High $380.19 | Professional | None | $223.87 | $346.74 | $380.19 |
United Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $251.19 | Facility | None | $229.09 | $229.09 | $251.19 |
United Setting Professional Modifier None Typical Low $158.49 Median $169.82 Typical High $251.19 | Professional | None | $158.49 | $169.82 | $251.19 |
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 $114.82 Median $147.91 Typical High $147.91 | Professional | 52 · Reduced service | $114.82 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $45.71 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $44.67 Typical High $44.67 | Professional | 55 · Aftercare only | $34.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $29.51 Typical High $29.51 | Professional | 56 · Pre-op care only | $22.91 | $29.51 | $29.51 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $257.04 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $229.09 | $257.04 | $269.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $147.91 Typical High $147.91 | Professional | 52 · Reduced service | $114.82 | $147.91 | $147.91 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $45.71 | $60.26 | $60.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $44.67 Typical High $44.67 | Professional | 55 · Aftercare only | $34.67 | $44.67 | $44.67 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $29.51 Typical High $29.51 | Professional | 56 · Pre-op care only | $22.91 | $29.51 | $29.51 |
Where Idaho sits
The same service costs 3.5 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· 14th of 51
$295
HI $589DE $166
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.