How much rates vary
Facilitymedian $589 · 10th to 90th $380 to $1,000Professionalmedian $513 · 10th to 90th $302 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 $389.05 Median $512.86 Typical High $512.86 | Professional | None | $389.05 | $512.86 | $512.86 |
BCBS Idaho Setting Facility Modifier None Typical Low $478.63 Median $588.84 Typical High $1,000.00 | Facility | None | $478.63 | $588.84 | $1,000.00 |
BCBS Idaho Setting Professional Modifier None Typical Low $436.52 Median $645.65 Typical High $676.08 | Professional | None | $436.52 | $645.65 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $446.68 | Facility | None | $426.58 | $426.58 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $426.58 | Professional | None | $309.03 | $309.03 | $426.58 |
Moda Health Setting Facility Modifier None Typical Low $194.98 Median $512.86 Typical High $616.60 | Facility | None | $194.98 | $512.86 | $616.60 |
Moda Health Setting Professional Modifier None Typical Low $426.58 Median $549.54 Typical High $645.65 | Professional | None | $426.58 | $549.54 | $645.65 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $446.68 Typical High $524.81 | Professional | None | $30.20 | $446.68 | $524.81 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $489.78 Median $776.25 Typical High $37,153.52 | Facility | None | $489.78 | $776.25 | $37,153.52 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $43,651.58 | Professional | None | $616.60 | $776.25 | $43,651.58 |
Regence BlueShield Setting Facility Modifier None Typical Low $575.44 Median $588.84 Typical High $891.25 | Facility | None | $575.44 | $588.84 | $891.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $645.65 | Professional | None | $436.52 | $436.52 | $645.65 |
Select Health Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $794.33 | Facility | None | $616.60 | $616.60 | $794.33 |
Select Health Setting Professional Modifier None Typical Low $398.11 Median $616.60 Typical High $676.08 | Professional | None | $398.11 | $616.60 | $676.08 |
United Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $380.19 | Facility | None | $338.84 | $338.84 | $380.19 |
United Setting Professional Modifier None Typical Low $275.42 Median $302.00 Typical High $467.74 | Professional | None | $275.42 | $302.00 | $467.74 |
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 $194.98 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $194.98 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $79.43 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $58.88 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $38.90 | $51.29 | $51.29 |
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 $194.98 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $194.98 | $257.04 | $257.04 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $79.43 | $102.33 | $102.33 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $58.88 | $75.86 | $75.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $38.90 | $51.29 | $51.29 |
Where Idaho sits
The same service costs 2.7 times more in Hawaii 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· 12th of 51
$525
HI $759KS $282
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.