How much rates vary
Facilitymedian $589 · 10th to 90th $309 to $1,000Professionalmedian $537 · 10th to 90th $229 to $776
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 $416.87 Median $537.03 Typical High $537.03 | Professional | None | $416.87 | $537.03 | $537.03 |
BCBS Idaho Setting Facility Modifier None Typical Low $446.68 Median $602.56 Typical High $1,000.00 | Facility | None | $446.68 | $602.56 | $1,000.00 |
BCBS Idaho Setting Professional Modifier None Typical Low $436.52 Median $660.69 Typical High $691.83 | Professional | None | $436.52 | $660.69 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $380.19 | Facility | None | $354.81 | $354.81 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $354.81 | Professional | None | $257.04 | $257.04 | $354.81 |
Moda Health Setting Facility Modifier None Typical Low $147.91 Median $537.03 Typical High $630.96 | Facility | None | $147.91 | $537.03 | $630.96 |
Moda Health Setting Professional Modifier None Typical Low $416.87 Median $562.34 Typical High $660.69 | Professional | None | $416.87 | $562.34 | $660.69 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $467.74 Typical High $537.03 | Professional | None | $30.20 | $467.74 | $537.03 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $389.05 Median $776.25 Typical High $37,153.52 | Facility | None | $389.05 | $776.25 | $37,153.52 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $630.96 Median $776.25 Typical High $43,651.58 | Professional | None | $630.96 | $776.25 | $43,651.58 |
Regence BlueShield Setting Facility Modifier None Typical Low $588.84 Median $602.56 Typical High $891.25 | Facility | None | $588.84 | $602.56 | $891.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $660.69 | Professional | None | $436.52 | $436.52 | $660.69 |
Select Health Setting Facility Modifier None Typical Low $575.44 Median $630.96 Typical High $794.33 | Facility | None | $575.44 | $630.96 | $794.33 |
Select Health Setting Professional Modifier None Typical Low $407.38 Median $630.96 Typical High $630.96 | Professional | None | $407.38 | $630.96 | $630.96 |
United Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $309.03 | Facility | None | $234.42 | $234.42 | $309.03 |
United Setting Professional Modifier None Typical Low $213.80 Median $229.09 Typical High $338.84 | Professional | None | $213.80 | $229.09 | $338.84 |
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 $208.93 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $208.93 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $83.18 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $61.66 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $41.69 | $53.70 | $53.70 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $457.09 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $407.38 | $457.09 | $478.63 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $208.93 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $208.93 | $269.15 | $269.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $83.18 | $107.15 | $107.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $61.66 | $81.28 | $81.28 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $41.69 | $53.70 | $53.70 |
Where Idaho sits
The same service costs 3.5 times more in Hawaii than in Florida. 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· 4th of 51
$537
HI $832FL $240
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.