How much rates vary
Facilitymedian $724 · 10th to 90th $372 to $1,202Professionalmedian $646 · 10th to 90th $275 to $955
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 $501.19 Median $645.65 Typical High $645.65 | Professional | None | $501.19 | $645.65 | $645.65 |
BCBS Idaho Setting Facility Modifier None Typical Low $537.03 Median $724.44 Typical High $1,202.26 | Facility | None | $537.03 | $724.44 | $1,202.26 |
BCBS Idaho Setting Professional Modifier None Typical Low $537.03 Median $794.33 Typical High $831.76 | Professional | None | $537.03 | $794.33 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $398.11 | Facility | None | $371.54 | $371.54 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $371.54 | Professional | None | $275.42 | $275.42 | $371.54 |
Moda Health Setting Facility Modifier None Typical Low $181.97 Median $645.65 Typical High $758.58 | Facility | None | $181.97 | $645.65 | $758.58 |
Moda Health Setting Professional Modifier None Typical Low $501.19 Median $691.83 Typical High $794.33 | Professional | None | $501.19 | $691.83 | $794.33 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $575.44 Typical High $660.69 | Professional | None | $30.20 | $575.44 | $660.69 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $512.86 Median $954.99 Typical High $45,708.82 | Facility | None | $512.86 | $954.99 | $45,708.82 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $53,703.18 | Professional | None | $758.58 | $954.99 | $53,703.18 |
Regence BlueShield Setting Facility Modifier None Typical Low $707.95 Median $724.44 Typical High $1,096.48 | Facility | None | $707.95 | $724.44 | $1,096.48 |
Regence BlueShield Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $794.33 | Professional | None | $537.03 | $537.03 | $794.33 |
Select Health Setting Facility Modifier None Typical Low $707.95 Median $758.58 Typical High $977.24 | Facility | None | $707.95 | $758.58 | $977.24 |
Select Health Setting Professional Modifier None Typical Low $489.78 Median $758.58 Typical High $831.76 | Professional | None | $489.78 | $758.58 | $831.76 |
United Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $371.54 | Facility | None | $269.15 | $269.15 | $371.54 |
United Setting Professional Modifier None Typical Low $257.04 Median $281.84 Typical High $416.87 | Professional | None | $257.04 | $281.84 | $416.87 |
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 $251.19 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $251.19 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $100.00 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $75.86 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $50.12 | $64.57 | $64.57 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $562.34 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $501.19 | $562.34 | $588.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $251.19 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $251.19 | $323.59 | $323.59 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $100.00 | $131.83 | $131.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $75.86 | $97.72 | $97.72 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $50.12 | $64.57 | $64.57 |
Where Idaho sits
The same service costs 3.0 times more in Hawaii than in Vermont. 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
$646
HI $813VT $275
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.