How much rates vary
Facilitymedian $851 · 10th to 90th $617 to $1,445Professionalmedian $741 · 10th to 90th $437 to $1,122
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 $562.34 Median $741.31 Typical High $741.31 | Professional | None | $562.34 | $741.31 | $741.31 |
BCBS Idaho Setting Facility Modifier None Typical Low $691.83 Median $851.14 Typical High $1,445.44 | Facility | None | $691.83 | $851.14 | $1,445.44 |
BCBS Idaho Setting Professional Modifier None Typical Low $630.96 Median $933.25 Typical High $977.24 | Professional | None | $630.96 | $933.25 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $676.08 | Facility | None | $616.60 | $616.60 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $616.60 | Professional | None | $446.68 | $446.68 | $616.60 |
Moda Health Setting Facility Modifier None Typical Low $281.84 Median $741.31 Typical High $891.25 | Facility | None | $281.84 | $741.31 | $891.25 |
Moda Health Setting Professional Modifier None Typical Low $562.34 Median $851.14 Typical High $933.25 | Professional | None | $562.34 | $851.14 | $933.25 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $645.65 Typical High $758.58 | Professional | None | $30.20 | $645.65 | $758.58 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $741.31 Median $1,122.02 Typical High $53,703.18 | Facility | None | $741.31 | $1,122.02 | $53,703.18 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $933.25 Median $1,122.02 Typical High $63,095.73 | Professional | None | $933.25 | $1,122.02 | $63,095.73 |
Regence BlueShield Setting Facility Modifier None Typical Low $831.76 Median $851.14 Typical High $1,288.25 | Facility | None | $831.76 | $851.14 | $1,288.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $933.25 | Professional | None | $630.96 | $630.96 | $933.25 |
Select Health Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $1,148.15 | Facility | None | $891.25 | $891.25 | $1,148.15 |
Select Health Setting Professional Modifier None Typical Low $575.44 Median $891.25 Typical High $977.24 | Professional | None | $575.44 | $891.25 | $977.24 |
United Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $707.95 | Facility | None | $588.84 | $588.84 | $707.95 |
United Setting Professional Modifier None Typical Low $407.38 Median $436.52 Typical High $676.08 | Professional | None | $407.38 | $436.52 | $676.08 |
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 $281.84 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $281.84 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $114.82 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $85.11 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $57.54 | $74.13 | $74.13 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $660.69 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $588.84 | $660.69 | $691.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $281.84 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $281.84 | $371.54 | $371.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $114.82 | $147.91 | $147.91 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $85.11 | $109.65 | $109.65 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $57.54 | $74.13 | $74.13 |
Where Idaho sits
The same service costs 3.7 times more in Hawaii than in Tennessee. 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· 13th of 51
$759
HI $1,660TN $447
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.