How much rates vary
Facilitymedian $589 · 10th to 90th $380 to $977Professionalmedian $513 · 10th to 90th $269 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 $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 $478.63 Median $588.84 Typical High $977.24 | Facility | None | $478.63 | $588.84 | $977.24 |
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 $398.11 Median $398.11 Typical High $416.87 | Facility | None | $398.11 | $398.11 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $398.11 | Professional | None | $288.40 | $288.40 | $398.11 |
Moda Health Setting Facility Modifier None Typical Low $173.78 Median $512.86 Typical High $616.60 | Facility | None | $173.78 | $512.86 | $616.60 |
Moda Health Setting Professional Modifier None Typical Low $398.11 Median $562.34 Typical High $645.65 | Professional | None | $398.11 | $562.34 | $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 $478.63 Median $776.25 Typical High $37,153.52 | Facility | None | $478.63 | $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 $602.56 Median $616.60 Typical High $794.33 | Facility | None | $602.56 | $616.60 | $794.33 |
Select Health Setting Professional Modifier None Typical Low $407.38 Median $616.60 Typical High $676.08 | Professional | None | $407.38 | $616.60 | $676.08 |
United Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $331.13 | Facility | None | $281.84 | $281.84 | $331.13 |
United Setting Professional Modifier None Typical Low $251.19 Median $269.15 Typical High $416.87 | Professional | None | $251.19 | $269.15 | $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 $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 $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 $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 $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 $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 $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 $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 2.6 times more in Hawaii than in Washington, DC. 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
$525
HI $741DC $288
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.