How much rates vary
Facilitymedian $708 · 10th to 90th $417 to $1,202Professionalmedian $617 · 10th to 90th $302 to $933
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 $616.60 Typical High $616.60 | Professional | None | $478.63 | $616.60 | $616.60 |
BCBS Idaho Setting Facility Modifier None Typical Low $537.03 Median $724.44 Typical High $1,202.26 | Facility | None | $537.03 | $724.44 | $1,202.26 |
BCBS Idaho Setting Professional Modifier None Typical Low $524.81 Median $794.33 Typical High $831.76 | Professional | None | $524.81 | $794.33 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $457.09 | Facility | None | $416.87 | $416.87 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $416.87 | Professional | None | $302.00 | $302.00 | $416.87 |
Moda Health Setting Facility Modifier None Typical Low $204.17 Median $616.60 Typical High $758.58 | Facility | None | $204.17 | $616.60 | $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 $537.03 Typical High $645.65 | Professional | None | $30.20 | $537.03 | $645.65 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $512.86 Median $933.25 Typical High $45,708.82 | Facility | None | $512.86 | $933.25 | $45,708.82 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $52,480.75 | Professional | None | $758.58 | $933.25 | $52,480.75 |
Regence BlueShield Setting Facility Modifier None Typical Low $707.95 Median $724.44 Typical High $1,071.52 | Facility | None | $707.95 | $724.44 | $1,071.52 |
Regence BlueShield Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $794.33 | Professional | None | $524.81 | $524.81 | $794.33 |
Select Health Setting Facility Modifier None Typical Low $691.83 Median $758.58 Typical High $977.24 | Facility | None | $691.83 | $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 $426.58 Median $426.58 Typical High $467.74 | Facility | None | $426.58 | $426.58 | $467.74 |
United Setting Professional Modifier None Typical Low $295.12 Median $316.23 Typical High $489.78 | Professional | None | $295.12 | $316.23 | $489.78 |
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 $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $239.88 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $123.03 Typical High $123.03 | Professional | 53 · Discontinued | $95.50 | $123.03 | $123.03 |
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 $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $47.86 | $61.66 | $61.66 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $549.54 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $489.78 | $549.54 | $575.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $239.88 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $239.88 | $309.03 | $309.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $123.03 Typical High $123.03 | Professional | 53 · Discontinued | $95.50 | $123.03 | $123.03 |
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 $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $47.86 | $61.66 | $61.66 |
Where Idaho sits
The same service costs 3.9 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· 8th of 51
$631
HI $1,175DE $302
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.