How much rates vary
Facilitymedian $603 · 10th to 90th $331 to $1,023Professionalmedian $513 · 10th to 90th $251 to $794
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 $398.11 Median $512.86 Typical High $512.86 | Professional | None | $398.11 | $512.86 | $512.86 |
BCBS Idaho Setting Facility Modifier None Typical Low $489.78 Median $602.56 Typical High $1,023.29 | Facility | None | $489.78 | $602.56 | $1,023.29 |
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 $346.74 Median $346.74 Typical High $363.08 | Facility | None | $346.74 | $346.74 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $346.74 | Professional | None | $251.19 | $251.19 | $346.74 |
Moda Health Setting Facility Modifier None Typical Low $162.18 Median $512.86 Typical High $630.96 | Facility | None | $162.18 | $512.86 | $630.96 |
Moda Health Setting Professional Modifier None Typical Low $398.11 Median $562.34 Typical High $660.69 | Professional | None | $398.11 | $562.34 | $660.69 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $457.09 Typical High $537.03 | Professional | None | $30.20 | $457.09 | $537.03 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $407.38 Median $794.33 Typical High $38,018.94 | Facility | None | $407.38 | $794.33 | $38,018.94 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $44,668.36 | Professional | None | $630.96 | $794.33 | $44,668.36 |
Regence BlueShield Setting Facility Modifier None Typical Low $588.84 Median $602.56 Typical High $912.01 | Facility | None | $588.84 | $602.56 | $912.01 |
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 $812.83 | Facility | None | $575.44 | $630.96 | $812.83 |
Select Health Setting Professional Modifier None Typical Low $407.38 Median $630.96 Typical High $660.69 | Professional | None | $407.38 | $630.96 | $660.69 |
United Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $251.19 | Facility | None | $173.78 | $173.78 | $251.19 |
United Setting Professional Modifier None Typical Low $229.09 Median $251.19 Typical High $389.05 | Professional | None | $229.09 | $251.19 | $389.05 |
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 $199.53 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $199.53 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $79.43 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $60.26 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $39.81 | $51.29 | $51.29 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $467.74 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $407.38 | $467.74 | $489.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $199.53 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $199.53 | $257.04 | $257.04 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $79.43 | $104.71 | $104.71 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $60.26 | $77.62 | $77.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $39.81 | $51.29 | $51.29 |
Where Idaho sits
The same service costs 2.9 times more in Iowa than in Kansas. 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· 6th of 51
$513
IA $603KS $209
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.