How much rates vary
Facilitymedian $676 · 10th to 90th $380 to $1,122Professionalmedian $575 · 10th to 90th $275 to $871
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 $446.68 Median $575.44 Typical High $575.44 | Professional | None | $446.68 | $575.44 | $575.44 |
BCBS Idaho Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $1,122.02 | Facility | None | $549.54 | $676.08 | $1,122.02 |
BCBS Idaho Setting Professional Modifier None Typical Low $489.78 Median $741.31 Typical High $776.25 | Professional | None | $489.78 | $741.31 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $416.87 | Facility | None | $380.19 | $380.19 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $380.19 | Professional | None | $275.42 | $275.42 | $380.19 |
Moda Health Setting Facility Modifier None Typical Low $190.55 Median $575.44 Typical High $707.95 | Facility | None | $190.55 | $575.44 | $707.95 |
Moda Health Setting Professional Modifier None Typical Low $446.68 Median $630.96 Typical High $741.31 | Professional | None | $446.68 | $630.96 | $741.31 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $501.19 Typical High $588.84 | Professional | None | $30.20 | $501.19 | $588.84 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $562.34 Median $870.96 Typical High $41,686.94 | Facility | None | $562.34 | $870.96 | $41,686.94 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $707.95 Median $870.96 Typical High $48,977.88 | Professional | None | $707.95 | $870.96 | $48,977.88 |
Regence BlueShield Setting Facility Modifier None Typical Low $660.69 Median $676.08 Typical High $1,000.00 | Facility | None | $660.69 | $676.08 | $1,000.00 |
Regence BlueShield Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $741.31 | Professional | None | $489.78 | $489.78 | $741.31 |
Select Health Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $891.25 | Facility | None | $707.95 | $707.95 | $891.25 |
Select Health Setting Professional Modifier None Typical Low $457.09 Median $707.95 Typical High $776.25 | Professional | None | $457.09 | $707.95 | $776.25 |
United Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $389.05 | Facility | None | $346.74 | $346.74 | $389.05 |
United Setting Professional Modifier None Typical Low $269.15 Median $295.12 Typical High $446.68 | Professional | None | $269.15 | $295.12 | $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 $223.87 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $223.87 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $89.13 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $67.61 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $44.67 | $57.54 | $57.54 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $512.86 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $457.09 | $512.86 | $537.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $223.87 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $223.87 | $288.40 | $288.40 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $89.13 | $114.82 | $114.82 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $67.61 | $87.10 | $87.10 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $44.67 | $57.54 | $57.54 |
Where Idaho sits
The same service costs 3.2 times more in Hawaii 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· 11th of 51
$589
HI $871DE $275
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.