How much rates vary
Facilitymedian $457 · 10th to 90th $263 to $776Professionalmedian $389 · 10th to 90th $200 to $589
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 $302.00 Median $389.05 Typical High $389.05 | Professional | None | $302.00 | $389.05 | $389.05 |
BCBS Idaho Setting Facility Modifier None Typical Low $371.54 Median $457.09 Typical High $776.25 | Facility | None | $371.54 | $457.09 | $776.25 |
BCBS Idaho Setting Professional Modifier None Typical Low $331.13 Median $501.19 Typical High $524.81 | Professional | None | $331.13 | $501.19 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $323.59 | Facility | None | $309.03 | $309.03 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $309.03 | Professional | None | $223.87 | $223.87 | $309.03 |
Moda Health Setting Facility Modifier None Typical Low $128.82 Median $389.05 Typical High $478.63 | Facility | None | $128.82 | $389.05 | $478.63 |
Moda Health Setting Professional Modifier None Typical Low $302.00 Median $426.58 Typical High $501.19 | Professional | None | $302.00 | $426.58 | $501.19 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $338.84 Typical High $398.11 | Professional | None | $30.20 | $338.84 | $398.11 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $323.59 Median $588.84 Typical High $28,183.83 | Facility | None | $323.59 | $588.84 | $28,183.83 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $478.63 Median $588.84 Typical High $33,113.11 | Professional | None | $478.63 | $588.84 | $33,113.11 |
Regence BlueShield Setting Facility Modifier None Typical Low $446.68 Median $457.09 Typical High $676.08 | Facility | None | $446.68 | $457.09 | $676.08 |
Regence BlueShield Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $501.19 | Professional | None | $331.13 | $331.13 | $501.19 |
Select Health Setting Facility Modifier None Typical Low $436.52 Median $478.63 Typical High $602.56 | Facility | None | $436.52 | $478.63 | $602.56 |
Select Health Setting Professional Modifier None Typical Low $309.03 Median $478.63 Typical High $524.81 | Professional | None | $309.03 | $478.63 | $524.81 |
United Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $245.47 | Facility | None | $218.78 | $218.78 | $245.47 |
United Setting Professional Modifier None Typical Low $181.97 Median $199.53 Typical High $309.03 | Professional | None | $181.97 | $199.53 | $309.03 |
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 $151.36 Median $194.98 Typical High $194.98 | Professional | 52 · Reduced service | $151.36 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $77.62 Typical High $77.62 | Professional | 53 · Discontinued | $60.26 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $45.71 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $30.20 | $38.90 | $38.90 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $346.74 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $309.03 | $346.74 | $363.08 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $151.36 Median $194.98 Typical High $194.98 | Professional | 52 · Reduced service | $151.36 | $194.98 | $194.98 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $77.62 Typical High $77.62 | Professional | 53 · Discontinued | $60.26 | $77.62 | $77.62 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $45.71 | $58.88 | $58.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $30.20 | $38.90 | $38.90 |
Where Idaho sits
The same service costs 2.5 times more in Hawaii than in Pennsylvania. 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
$398
HI $525PA $214
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.