How much rates vary
Facilitymedian $692 · 10th to 90th $363 to $1,175Professionalmedian $617 · 10th to 90th $288 to $933
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 $467.74 Median $616.60 Typical High $616.60 | Professional | None | $467.74 | $616.60 | $616.60 |
BCBS Idaho Setting Facility Modifier None Typical Low $524.81 Median $707.95 Typical High $1,174.90 | Facility | None | $524.81 | $707.95 | $1,174.90 |
BCBS Idaho Setting Professional Modifier None Typical Low $512.86 Median $776.25 Typical High $812.83 | Professional | None | $512.86 | $776.25 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $524.81 | Facility | None | $501.19 | $501.19 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $501.19 | Professional | None | $363.08 | $363.08 | $501.19 |
Moda Health Setting Facility Modifier None Typical Low $186.21 Median $602.56 Typical High $741.31 | Facility | None | $186.21 | $602.56 | $741.31 |
Moda Health Setting Professional Modifier None Typical Low $467.74 Median $660.69 Typical High $776.25 | Professional | None | $467.74 | $660.69 | $776.25 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $537.03 Typical High $630.96 | Professional | None | $30.20 | $537.03 | $630.96 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $467.74 Median $933.25 Typical High $44,668.36 | Facility | None | $467.74 | $933.25 | $44,668.36 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $741.31 Median $933.25 Typical High $52,480.75 | Professional | None | $741.31 | $933.25 | $52,480.75 |
Regence BlueShield Setting Facility Modifier None Typical Low $691.83 Median $707.95 Typical High $1,071.52 | Facility | None | $691.83 | $707.95 | $1,071.52 |
Regence BlueShield Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $776.25 | Professional | None | $512.86 | $512.86 | $776.25 |
Select Health Setting Facility Modifier None Typical Low $691.83 Median $741.31 Typical High $954.99 | Facility | None | $691.83 | $741.31 | $954.99 |
Select Health Setting Professional Modifier None Typical Low $478.63 Median $741.31 Typical High $776.25 | Professional | None | $478.63 | $741.31 | $776.25 |
United Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $288.40 | Facility | None | $229.09 | $229.09 | $288.40 |
United Setting Professional Modifier None Typical Low $269.15 Median $288.40 Typical High $446.68 | Professional | None | $269.15 | $288.40 | $446.68 |
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 $234.42 Median $302.00 Typical High $302.00 | Professional | 52 · Reduced service | $234.42 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $123.03 Typical High $123.03 | Professional | 53 · Discontinued | $93.33 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $70.79 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $46.77 | $61.66 | $61.66 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $549.54 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $489.78 | $549.54 | $575.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $234.42 Median $302.00 Typical High $302.00 | Professional | 52 · Reduced service | $234.42 | $302.00 | $302.00 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $123.03 Typical High $123.03 | Professional | 53 · Discontinued | $93.33 | $123.03 | $123.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $70.79 | $91.20 | $91.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $46.77 | $61.66 | $61.66 |
Where Idaho sits
The same service costs 2.3 times more in Wisconsin 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
$617
WI $776FL $339
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.