How much rates vary
Facilitymedian $363 · 10th to 90th $219 to $617Professionalmedian $316 · 10th to 90th $170 to $479
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 $316.23 Typical High $316.23 | Professional | None | $245.47 | $316.23 | $316.23 |
BCBS Idaho Setting Facility Modifier None Typical Low $295.12 Median $363.08 Typical High $616.60 | Facility | None | $295.12 | $363.08 | $616.60 |
BCBS Idaho Setting Professional Modifier None Typical Low $269.15 Median $398.11 Typical High $416.87 | Professional | None | $269.15 | $398.11 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $288.40 | Facility | None | $269.15 | $269.15 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $269.15 | Professional | None | $199.53 | $199.53 | $269.15 |
Moda Health Setting Facility Modifier None Typical Low $109.65 Median $316.23 Typical High $380.19 | Facility | None | $109.65 | $316.23 | $380.19 |
Moda Health Setting Professional Modifier None Typical Low $245.47 Median $346.74 Typical High $398.11 | Professional | None | $245.47 | $346.74 | $398.11 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $275.42 Typical High $323.59 | Professional | None | $30.20 | $275.42 | $323.59 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $269.15 Median $478.63 Typical High $22,908.68 | Facility | None | $269.15 | $478.63 | $22,908.68 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $380.19 Median $478.63 Typical High $26,915.35 | Professional | None | $380.19 | $478.63 | $26,915.35 |
Regence BlueShield Setting Facility Modifier None Typical Low $354.81 Median $363.08 Typical High $549.54 | Facility | None | $354.81 | $363.08 | $549.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $398.11 | Professional | None | $269.15 | $269.15 | $398.11 |
Select Health Setting Facility Modifier None Typical Low $354.81 Median $380.19 Typical High $489.78 | Facility | None | $354.81 | $380.19 | $489.78 |
Select Health Setting Professional Modifier None Typical Low $251.19 Median $380.19 Typical High $416.87 | Professional | None | $251.19 | $380.19 | $416.87 |
United Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $173.78 | Facility | None | $158.49 | $158.49 | $173.78 |
United Setting Professional Modifier None Typical Low $154.88 Median $169.82 Typical High $257.04 | Professional | None | $154.88 | $169.82 | $257.04 |
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 $123.03 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $123.03 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $48.98 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $46.77 Typical High $46.77 | Professional | 55 · Aftercare only | $36.31 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $24.55 | $31.62 | $31.62 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $281.84 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $251.19 | $281.84 | $295.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $123.03 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $123.03 | $158.49 | $158.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $48.98 | $63.10 | $63.10 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $46.77 Typical High $46.77 | Professional | 55 · Aftercare only | $36.31 | $46.77 | $46.77 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $24.55 | $31.62 | $31.62 |
Where Idaho sits
The same service costs 2.0 times more in Wisconsin than in Colorado. 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· 13th of 51
$324
WI $407CO $200
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.