How much rates vary
Facilitymedian $398 · 10th to 90th $263 to $692Professionalmedian $363 · 10th to 90th $195 to $525
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 $245.47 Median $363.08 Typical High $363.08 | Professional | None | $245.47 | $363.08 | $363.08 |
BCBS Idaho Setting Facility Modifier None Typical Low $323.59 Median $398.11 Typical High $691.83 | Facility | None | $323.59 | $398.11 | $691.83 |
BCBS Idaho Setting Professional Modifier None Typical Low $295.12 Median $436.52 Typical High $457.09 | Professional | None | $295.12 | $436.52 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $295.12 | Facility | None | $263.03 | $263.03 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $263.03 | Professional | None | $194.98 | $194.98 | $263.03 |
Moda Health Setting Facility Modifier None Typical Low $131.83 Median $363.08 Typical High $416.87 | Facility | None | $131.83 | $363.08 | $416.87 |
Moda Health Setting Professional Modifier None Typical Low $275.42 Median $363.08 Typical High $436.52 | Professional | None | $275.42 | $363.08 | $436.52 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $302.00 Typical High $354.81 | Professional | None | $30.20 | $302.00 | $354.81 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $338.84 Median $524.81 Typical High $25,118.86 | Facility | None | $338.84 | $524.81 | $25,118.86 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $29,512.09 | Professional | None | $416.87 | $524.81 | $29,512.09 |
Regence BlueShield Setting Facility Modifier None Typical Low $389.05 Median $398.11 Typical High $602.56 | Facility | None | $389.05 | $398.11 | $602.56 |
Regence BlueShield Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $436.52 | Professional | None | $295.12 | $295.12 | $436.52 |
Select Health Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $537.03 | Facility | None | $416.87 | $416.87 | $537.03 |
Select Health Setting Professional Modifier None Typical Low $275.42 Median $416.87 Typical High $457.09 | Professional | None | $275.42 | $416.87 | $457.09 |
United Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $275.42 | Facility | None | $213.80 | $213.80 | $275.42 |
United Setting Professional Modifier None Typical Low $190.55 Median $204.17 Typical High $302.00 | Professional | None | $190.55 | $204.17 | $302.00 |
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 $138.04 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $138.04 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $72.44 Typical High $72.44 | Professional | 53 · Discontinued | $54.95 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $41.69 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $27.54 | $36.31 | $36.31 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $309.03 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $275.42 | $309.03 | $323.59 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $138.04 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $138.04 | $181.97 | $181.97 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $72.44 Typical High $72.44 | Professional | 53 · Discontinued | $54.95 | $72.44 | $72.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $41.69 | $53.70 | $53.70 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $27.54 | $36.31 | $36.31 |
Where Idaho sits
The same service costs 4.7 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· 12th of 51
$363
HI $912DE $195
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.