How much rates vary
Facilitymedian $776 · 10th to 90th $380 to $1,288Professionalmedian $676 · 10th to 90th $275 to $1,023
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 $512.86 Median $676.08 Typical High $676.08 | Professional | None | $512.86 | $676.08 | $676.08 |
BCBS Idaho Setting Facility Modifier None Typical Low $630.96 Median $776.25 Typical High $1,288.25 | Facility | None | $630.96 | $776.25 | $1,288.25 |
BCBS Idaho Setting Professional Modifier None Typical Low $562.34 Median $851.14 Typical High $891.25 | Professional | None | $562.34 | $851.14 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $426.58 | Facility | None | $380.19 | $380.19 | $426.58 |
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 $676.08 Typical High $812.83 | Facility | None | $190.55 | $676.08 | $812.83 |
Moda Health Setting Professional Modifier None Typical Low $512.86 Median $676.08 Typical High $851.14 | Professional | None | $512.86 | $676.08 | $851.14 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $588.84 Typical High $691.83 | Professional | None | $30.20 | $588.84 | $691.83 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $645.65 Median $1,023.29 Typical High $48,977.88 | Facility | None | $645.65 | $1,023.29 | $48,977.88 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $57,543.99 | Professional | None | $812.83 | $1,023.29 | $57,543.99 |
Regence BlueShield Setting Facility Modifier None Typical Low $758.58 Median $776.25 Typical High $1,174.90 | Facility | None | $758.58 | $776.25 | $1,174.90 |
Regence BlueShield Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $851.14 | Professional | None | $562.34 | $562.34 | $851.14 |
Select Health Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $1,047.13 | Facility | None | $812.83 | $812.83 | $1,047.13 |
Select Health Setting Professional Modifier None Typical Low $524.81 Median $812.83 Typical High $891.25 | Professional | None | $524.81 | $812.83 | $891.25 |
United Setting Professional Modifier None Typical Low $275.42 Median $295.12 Typical High $457.09 | Professional | None | $275.42 | $295.12 | $457.09 |
5 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 55 · Aftercare only Typical Low $77.62 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $77.62 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $51.29 | $67.61 | $67.61 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $602.56 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $537.03 | $602.56 | $630.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $77.62 | $100.00 | $100.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $51.29 | $67.61 | $67.61 |
Where Idaho sits
The same service costs 3.7 times more in Alaska 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· 10th of 51
$676
AK $1,023DE $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.