How much rates vary
Facilitymedian $724 · 10th to 90th $389 to $1,230Professionalmedian $631 · 10th to 90th $282 to $955
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 $478.63 Median $630.96 Typical High $630.96 | Professional | None | $478.63 | $630.96 | $630.96 |
BCBS Idaho Setting Facility Modifier None Typical Low $588.84 Median $724.44 Typical High $1,230.27 | Facility | None | $588.84 | $724.44 | $1,230.27 |
BCBS Idaho Setting Professional Modifier None Typical Low $537.03 Median $794.33 Typical High $831.76 | Professional | None | $537.03 | $794.33 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $416.87 | Facility | None | $389.05 | $389.05 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $389.05 | Professional | None | $281.84 | $281.84 | $389.05 |
Moda Health Setting Facility Modifier None Typical Low $199.53 Median $630.96 Typical High $758.58 | Facility | None | $199.53 | $630.96 | $758.58 |
Moda Health Setting Professional Modifier None Typical Low $478.63 Median $676.08 Typical High $794.33 | Professional | None | $478.63 | $676.08 | $794.33 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $549.54 Typical High $645.65 | Professional | None | $30.20 | $549.54 | $645.65 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $501.19 Median $954.99 Typical High $45,708.82 | Facility | None | $501.19 | $954.99 | $45,708.82 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $53,703.18 | Professional | None | $758.58 | $954.99 | $53,703.18 |
Regence BlueShield Setting Facility Modifier None Typical Low $707.95 Median $724.44 Typical High $1,096.48 | Facility | None | $707.95 | $724.44 | $1,096.48 |
Regence BlueShield Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $794.33 | Professional | None | $537.03 | $537.03 | $794.33 |
Select Health Setting Facility Modifier None Typical Low $707.95 Median $758.58 Typical High $977.24 | Facility | None | $707.95 | $758.58 | $977.24 |
Select Health Setting Professional Modifier None Typical Low $489.78 Median $758.58 Typical High $831.76 | Professional | None | $489.78 | $758.58 | $831.76 |
United Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $331.13 | Facility | None | $281.84 | $281.84 | $331.13 |
United Setting Professional Modifier None Typical Low $288.40 Median $309.03 Typical High $478.63 | Professional | None | $288.40 | $309.03 | $478.63 |
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 $239.88 Median $316.23 Typical High $316.23 | Professional | 52 · Reduced service | $239.88 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $97.72 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $93.33 Typical High $93.33 | Professional | 55 · Aftercare only | $72.44 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $47.86 | $63.10 | $63.10 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $562.34 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $501.19 | $562.34 | $588.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $239.88 Median $316.23 Typical High $316.23 | Professional | 52 · Reduced service | $239.88 | $316.23 | $316.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $97.72 | $125.89 | $125.89 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $93.33 Typical High $93.33 | Professional | 55 · Aftercare only | $72.44 | $93.33 | $93.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $47.86 | $63.10 | $63.10 |
Where Idaho sits
The same service costs 2.6 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· 5th of 51
$631
HI $724DE $282
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.