How much rates vary
Facilitymedian $288 · 10th to 90th $138 to $479Professionalmedian $251 · 10th to 90th $102 to $380
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 $190.55 Median $251.19 Typical High $251.19 | Professional | None | $190.55 | $251.19 | $251.19 |
BCBS Idaho Setting Facility Modifier None Typical Low $213.80 Median $288.40 Typical High $478.63 | Facility | None | $213.80 | $288.40 | $478.63 |
BCBS Idaho Setting Professional Modifier None Typical Low $213.80 Median $316.23 Typical High $331.13 | Professional | None | $213.80 | $316.23 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $154.88 | Facility | None | $138.04 | $138.04 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $138.04 | Professional | None | $102.33 | $102.33 | $138.04 |
Moda Health Setting Facility Modifier None Typical Low $70.79 Median $251.19 Typical High $302.00 | Facility | None | $70.79 | $251.19 | $302.00 |
Moda Health Setting Professional Modifier None Typical Low $190.55 Median $269.15 Typical High $316.23 | Professional | None | $190.55 | $269.15 | $316.23 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $218.78 Typical High $257.04 | Professional | None | $30.20 | $218.78 | $257.04 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $177.83 Median $380.19 Typical High $18,197.01 | Facility | None | $177.83 | $380.19 | $18,197.01 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $302.00 Median $380.19 Typical High $21,379.62 | Professional | None | $302.00 | $380.19 | $21,379.62 |
Regence BlueShield Setting Facility Modifier None Typical Low $281.84 Median $288.40 Typical High $436.52 | Facility | None | $281.84 | $288.40 | $436.52 |
Regence BlueShield Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $316.23 | Professional | None | $213.80 | $213.80 | $316.23 |
Select Health Setting Facility Modifier None Typical Low $281.84 Median $302.00 Typical High $389.05 | Facility | None | $281.84 | $302.00 | $389.05 |
Select Health Setting Professional Modifier None Typical Low $194.98 Median $302.00 Typical High $302.00 | Professional | None | $194.98 | $302.00 | $302.00 |
United Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $154.88 | Facility | None | $147.91 | $147.91 | $154.88 |
United Setting Professional Modifier None Typical Low $102.33 Median $109.65 Typical High $169.82 | Professional | None | $102.33 | $109.65 | $169.82 |
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 $95.50 Median $123.03 Typical High $123.03 | Professional | 52 · Reduced service | $95.50 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $50.12 Typical High $50.12 | Professional | 53 · Discontinued | $38.90 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $37.15 Typical High $37.15 | Professional | 55 · Aftercare only | $28.84 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $25.12 Typical High $25.12 | Professional | 56 · Pre-op care only | $19.05 | $25.12 | $25.12 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $223.87 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $199.53 | $223.87 | $234.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $123.03 Typical High $123.03 | Professional | 52 · Reduced service | $95.50 | $123.03 | $123.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $50.12 Typical High $50.12 | Professional | 53 · Discontinued | $38.90 | $50.12 | $50.12 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $37.15 Typical High $37.15 | Professional | 55 · Aftercare only | $28.84 | $37.15 | $37.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $25.12 Typical High $25.12 | Professional | 56 · Pre-op care only | $19.05 | $25.12 | $25.12 |
Where Idaho sits
The same service costs 3.5 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· 4th of 51
$251
HI $363DE $102
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.