How much rates vary
Facilitymedian $347 · 10th to 90th $166 to $589Professionalmedian $302 · 10th to 90th $120 to $457
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 $229.09 Median $302.00 Typical High $302.00 | Professional | None | $229.09 | $302.00 | $302.00 |
BCBS Idaho Setting Facility Modifier None Typical Low $281.84 Median $346.74 Typical High $588.84 | Facility | None | $281.84 | $346.74 | $588.84 |
BCBS Idaho Setting Professional Modifier None Typical Low $251.19 Median $380.19 Typical High $398.11 | Professional | None | $251.19 | $380.19 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $177.83 | Facility | None | $165.96 | $165.96 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $165.96 | Professional | None | $120.23 | $120.23 | $165.96 |
Moda Health Setting Facility Modifier None Typical Low $85.11 Median $302.00 Typical High $363.08 | Facility | None | $85.11 | $302.00 | $363.08 |
Moda Health Setting Professional Modifier None Typical Low $229.09 Median $323.59 Typical High $380.19 | Professional | None | $229.09 | $323.59 | $380.19 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $263.03 Typical High $309.03 | Professional | None | $30.20 | $263.03 | $309.03 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $263.03 Median $457.09 Typical High $21,877.62 | Facility | None | $263.03 | $457.09 | $21,877.62 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $363.08 Median $457.09 Typical High $25,703.96 | Professional | None | $363.08 | $457.09 | $25,703.96 |
Regence BlueShield Setting Facility Modifier None Typical Low $338.84 Median $346.74 Typical High $524.81 | Facility | None | $338.84 | $346.74 | $524.81 |
Regence BlueShield Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $380.19 | Professional | None | $251.19 | $251.19 | $380.19 |
Select Health Setting Facility Modifier None Typical Low $331.13 Median $363.08 Typical High $467.74 | Facility | None | $331.13 | $363.08 | $467.74 |
Select Health Setting Professional Modifier None Typical Low $234.42 Median $363.08 Typical High $398.11 | Professional | None | $234.42 | $363.08 | $398.11 |
United Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $141.25 | Facility | None | $134.90 | $134.90 | $141.25 |
United Setting Professional Modifier None Typical Low $123.03 Median $131.83 Typical High $204.17 | Professional | None | $123.03 | $131.83 | $204.17 |
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 $114.82 Median $147.91 Typical High $147.91 | Professional | 52 · Reduced service | $114.82 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $45.71 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $44.67 Typical High $44.67 | Professional | 55 · Aftercare only | $34.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $30.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $22.91 | $30.20 | $30.20 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $269.15 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $239.88 | $269.15 | $281.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $147.91 Typical High $147.91 | Professional | 52 · Reduced service | $114.82 | $147.91 | $147.91 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $45.71 | $60.26 | $60.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $44.67 Typical High $44.67 | Professional | 55 · Aftercare only | $34.67 | $44.67 | $44.67 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $30.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $22.91 | $30.20 | $30.20 |
Where Idaho sits
The same service costs 2.8 times more in Montana than in Delaware. 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· 9th of 51
$302
MT $331DE $120
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.