How much rates vary
Facilitymedian $513 · 10th to 90th $339 to $871Professionalmedian $437 · 10th to 90th $245 to $661
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 $338.84 Median $436.52 Typical High $436.52 | Professional | None | $338.84 | $436.52 | $436.52 |
BCBS Idaho Setting Facility Modifier None Typical Low $416.87 Median $512.86 Typical High $870.96 | Facility | None | $416.87 | $512.86 | $870.96 |
BCBS Idaho Setting Professional Modifier None Typical Low $371.54 Median $562.34 Typical High $588.84 | Professional | None | $371.54 | $562.34 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $354.81 | Facility | None | $338.84 | $338.84 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $338.84 | Professional | None | $245.47 | $245.47 | $338.84 |
Moda Health Setting Facility Modifier None Typical Low $169.82 Median $436.52 Typical High $537.03 | Facility | None | $169.82 | $436.52 | $537.03 |
Moda Health Setting Professional Modifier None Typical Low $338.84 Median $478.63 Typical High $562.34 | Professional | None | $338.84 | $478.63 | $562.34 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $380.19 Typical High $457.09 | Professional | None | $30.20 | $380.19 | $457.09 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $457.09 Median $660.69 Typical High $32,359.37 | Facility | None | $457.09 | $660.69 | $32,359.37 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $562.34 Median $660.69 Typical High $37,153.52 | Professional | None | $562.34 | $660.69 | $37,153.52 |
Regence BlueShield Setting Facility Modifier None Typical Low $501.19 Median $512.86 Typical High $758.58 | Facility | None | $501.19 | $512.86 | $758.58 |
Regence BlueShield Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $562.34 | Professional | None | $371.54 | $371.54 | $562.34 |
Select Health Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $707.95 | Facility | None | $537.03 | $537.03 | $707.95 |
Select Health Setting Professional Modifier None Typical Low $346.74 Median $537.03 Typical High $588.84 | Professional | None | $346.74 | $537.03 | $588.84 |
United Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $363.08 | Facility | None | $263.03 | $263.03 | $363.08 |
United Setting Professional Modifier None Typical Low $239.88 Median $263.03 Typical High $398.11 | Professional | None | $239.88 | $263.03 | $398.11 |
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 $169.82 Median $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $169.82 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $67.61 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $51.29 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $33.88 | $43.65 | $43.65 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $389.05 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $346.74 | $389.05 | $407.38 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $169.82 Median $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $169.82 | $218.78 | $218.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $67.61 | $87.10 | $87.10 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $51.29 | $66.07 | $66.07 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $33.88 | $43.65 | $43.65 |
Where Idaho sits
The same service costs 2.8 times more in Wyoming 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
$457
WY $676DE $245
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.