How much rates vary
Facilitymedian $363 · 10th to 90th $174 to $617Professionalmedian $316 · 10th to 90th $129 to $479
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 $239.88 Median $316.23 Typical High $316.23 | Professional | None | $239.88 | $316.23 | $316.23 |
BCBS Idaho Setting Facility Modifier None Typical Low $295.12 Median $363.08 Typical High $616.60 | Facility | None | $295.12 | $363.08 | $616.60 |
BCBS Idaho Setting Professional Modifier None Typical Low $269.15 Median $398.11 Typical High $416.87 | Professional | None | $269.15 | $398.11 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $194.98 | Facility | None | $173.78 | $173.78 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $173.78 | Professional | None | $128.82 | $128.82 | $173.78 |
Moda Health Setting Facility Modifier None Typical Low $89.13 Median $316.23 Typical High $380.19 | Facility | None | $89.13 | $316.23 | $380.19 |
Moda Health Setting Professional Modifier None Typical Low $239.88 Median $338.84 Typical High $398.11 | Professional | None | $239.88 | $338.84 | $398.11 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $275.42 Typical High $323.59 | Professional | None | $30.20 | $275.42 | $323.59 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $229.09 Median $478.63 Typical High $22,908.68 | Facility | None | $229.09 | $478.63 | $22,908.68 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $380.19 Median $478.63 Typical High $26,915.35 | Professional | None | $380.19 | $478.63 | $26,915.35 |
Regence BlueShield Setting Facility Modifier None Typical Low $354.81 Median $363.08 Typical High $549.54 | Facility | None | $354.81 | $363.08 | $549.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $398.11 | Professional | None | $269.15 | $269.15 | $398.11 |
Select Health Setting Facility Modifier None Typical Low $354.81 Median $380.19 Typical High $489.78 | Facility | None | $354.81 | $380.19 | $489.78 |
Select Health Setting Professional Modifier None Typical Low $245.47 Median $380.19 Typical High $380.19 | Professional | None | $245.47 | $380.19 | $380.19 |
United Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $229.09 | Facility | None | $186.21 | $186.21 | $229.09 |
United Setting Professional Modifier None Typical Low $128.82 Median $138.04 Typical High $213.80 | Professional | None | $128.82 | $138.04 | $213.80 |
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 $120.23 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $120.23 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $48.98 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $46.77 Typical High $46.77 | Professional | 55 · Aftercare only | $36.31 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $23.99 | $31.62 | $31.62 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $281.84 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $251.19 | $281.84 | $295.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $120.23 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $120.23 | $158.49 | $158.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $48.98 | $63.10 | $63.10 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $46.77 Typical High $46.77 | Professional | 55 · Aftercare only | $36.31 | $46.77 | $46.77 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $23.99 | $31.62 | $31.62 |
Where Idaho sits
The same service costs 4.0 times more in Hawaii than in Florida. 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
$316
HI $525FL $132
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.