How much rates vary
Facilitymedian $417 · 10th to 90th $229 to $708Professionalmedian $355 · 10th to 90th $166 to $537
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 $275.42 Median $354.81 Typical High $354.81 | Professional | None | $275.42 | $354.81 | $354.81 |
BCBS Idaho Setting Facility Modifier None Typical Low $338.84 Median $416.87 Typical High $707.95 | Facility | None | $338.84 | $416.87 | $707.95 |
BCBS Idaho Setting Professional Modifier None Typical Low $302.00 Median $457.09 Typical High $478.63 | Professional | None | $302.00 | $457.09 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $239.88 | Facility | None | $229.09 | $229.09 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $229.09 | Professional | None | $165.96 | $165.96 | $229.09 |
Moda Health Setting Facility Modifier None Typical Low $117.49 Median $354.81 Typical High $436.52 | Facility | None | $117.49 | $354.81 | $436.52 |
Moda Health Setting Professional Modifier None Typical Low $275.42 Median $389.05 Typical High $457.09 | Professional | None | $275.42 | $389.05 | $457.09 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $309.03 Typical High $371.54 | Professional | None | $30.20 | $309.03 | $371.54 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $346.74 Median $537.03 Typical High $26,302.68 | Facility | None | $346.74 | $537.03 | $26,302.68 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $436.52 Median $537.03 Typical High $30,902.95 | Professional | None | $436.52 | $537.03 | $30,902.95 |
Regence BlueShield Setting Facility Modifier None Typical Low $407.38 Median $416.87 Typical High $616.60 | Facility | None | $407.38 | $416.87 | $616.60 |
Regence BlueShield Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $457.09 | Professional | None | $302.00 | $302.00 | $457.09 |
Select Health Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $562.34 | Facility | None | $436.52 | $436.52 | $562.34 |
Select Health Setting Professional Modifier None Typical Low $281.84 Median $436.52 Typical High $478.63 | Professional | None | $281.84 | $436.52 | $478.63 |
United Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $190.55 | Facility | None | $151.36 | $151.36 | $190.55 |
United Setting Professional Modifier None Typical Low $169.82 Median $181.97 Typical High $281.84 | Professional | None | $169.82 | $181.97 | $281.84 |
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 $138.04 Median $177.83 Typical High $177.83 | Professional | 52 · Reduced service | $138.04 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $70.79 Typical High $70.79 | Professional | 53 · Discontinued | $54.95 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $41.69 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $35.48 Typical High $35.48 | Professional | 56 · Pre-op care only | $27.54 | $35.48 | $35.48 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $316.23 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $281.84 | $316.23 | $331.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $138.04 Median $177.83 Typical High $177.83 | Professional | 52 · Reduced service | $138.04 | $177.83 | $177.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $70.79 Typical High $70.79 | Professional | 53 · Discontinued | $54.95 | $70.79 | $70.79 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $41.69 | $53.70 | $53.70 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $35.48 Typical High $35.48 | Professional | 56 · Pre-op care only | $27.54 | $35.48 | $35.48 |
Where Idaho sits
The same service costs 2.7 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· 7th of 51
$372
MT $457DE $170
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.