How much rates vary
Facilitymedian $224 · 10th to 90th $148 to $380Professionalmedian $195 · 10th to 90th $110 to $295
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 $147.91 Median $194.98 Typical High $194.98 | Professional | None | $147.91 | $194.98 | $194.98 |
BCBS Idaho Setting Facility Modifier None Typical Low $181.97 Median $223.87 Typical High $380.19 | Facility | None | $181.97 | $223.87 | $380.19 |
BCBS Idaho Setting Professional Modifier None Typical Low $165.96 Median $245.47 Typical High $257.04 | Professional | None | $165.96 | $245.47 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $190.55 | Facility | None | $181.97 | $181.97 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $181.97 | Professional | None | $131.83 | $131.83 | $181.97 |
Moda Health Setting Facility Modifier None Typical Low $70.79 Median $194.98 Typical High $234.42 | Facility | None | $70.79 | $194.98 | $234.42 |
Moda Health Setting Professional Modifier None Typical Low $147.91 Median $208.93 Typical High $245.47 | Professional | None | $147.91 | $208.93 | $245.47 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $169.82 Typical High $199.53 | Professional | None | $30.20 | $169.82 | $199.53 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $177.83 Median $295.12 Typical High $14,125.38 | Facility | None | $177.83 | $295.12 | $14,125.38 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $234.42 Median $295.12 Typical High $16,595.87 | Professional | None | $234.42 | $295.12 | $16,595.87 |
Regence BlueShield Setting Facility Modifier None Typical Low $218.78 Median $223.87 Typical High $338.84 | Facility | None | $218.78 | $223.87 | $338.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $245.47 | Professional | None | $165.96 | $165.96 | $245.47 |
Select Health Setting Facility Modifier None Typical Low $229.09 Median $234.42 Typical High $302.00 | Facility | None | $229.09 | $234.42 | $302.00 |
Select Health Setting Professional Modifier None Typical Low $151.36 Median $234.42 Typical High $257.04 | Professional | None | $151.36 | $234.42 | $257.04 |
United Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $173.78 | Facility | None | $147.91 | $147.91 | $173.78 |
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 $74.13 Median $97.72 Typical High $97.72 | Professional | 52 · Reduced service | $74.13 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $38.90 Typical High $38.90 | Professional | 53 · Discontinued | $30.20 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $22.39 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $19.50 Typical High $19.50 | Professional | 56 · Pre-op care only | $14.79 | $19.50 | $19.50 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $173.78 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $154.88 | $173.78 | $181.97 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $74.13 Median $97.72 Typical High $97.72 | Professional | 52 · Reduced service | $74.13 | $97.72 | $97.72 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $38.90 Typical High $38.90 | Professional | 53 · Discontinued | $30.20 | $38.90 | $38.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $22.39 | $28.84 | $28.84 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $19.50 Typical High $19.50 | Professional | 56 · Pre-op care only | $14.79 | $19.50 | $19.50 |
Where Idaho sits
The same service costs 3.5 times more in Hawaii than in Washington, DC. 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
$200
HI $427DC $120
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.