How much rates vary
Facilitymedian $282 · 10th to 90th $178 to $457Professionalmedian $240 · 10th to 90th $129 to $363
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 $186.21 Median $239.88 Typical High $239.88 | Professional | None | $186.21 | $239.88 | $239.88 |
BCBS Idaho Setting Facility Modifier None Typical Low $208.93 Median $281.84 Typical High $457.09 | Facility | None | $208.93 | $281.84 | $457.09 |
BCBS Idaho Setting Professional Modifier None Typical Low $204.17 Median $309.03 Typical High $323.59 | Professional | None | $204.17 | $309.03 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $194.98 | Facility | None | $177.83 | $177.83 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $177.83 | Professional | None | $128.82 | $128.82 | $177.83 |
Moda Health Setting Facility Modifier None Typical Low $89.13 Median $239.88 Typical High $288.40 | Facility | None | $89.13 | $239.88 | $288.40 |
Moda Health Setting Professional Modifier None Typical Low $186.21 Median $263.03 Typical High $309.03 | Professional | None | $186.21 | $263.03 | $309.03 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $208.93 Typical High $245.47 | Professional | None | $30.20 | $208.93 | $245.47 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $234.42 Median $363.08 Typical High $17,378.01 | Facility | None | $234.42 | $363.08 | $17,378.01 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $288.40 Median $363.08 Typical High $20,417.38 | Professional | None | $288.40 | $363.08 | $20,417.38 |
Regence BlueShield Setting Facility Modifier None Typical Low $269.15 Median $281.84 Typical High $416.87 | Facility | None | $269.15 | $281.84 | $416.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $309.03 | Professional | None | $204.17 | $204.17 | $309.03 |
Select Health Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $371.54 | Facility | None | $288.40 | $288.40 | $371.54 |
Select Health Setting Professional Modifier None Typical Low $190.55 Median $288.40 Typical High $316.23 | Professional | None | $190.55 | $288.40 | $316.23 |
United Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $208.93 | Facility | None | $186.21 | $186.21 | $208.93 |
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 $93.33 Median $120.23 Typical High $120.23 | Professional | 52 · Reduced service | $93.33 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $47.86 Typical High $47.86 | Professional | 53 · Discontinued | $37.15 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $36.31 Typical High $36.31 | Professional | 55 · Aftercare only | $27.54 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $23.99 Typical High $23.99 | Professional | 56 · Pre-op care only | $18.62 | $23.99 | $23.99 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $213.80 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $190.55 | $213.80 | $223.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $93.33 Median $120.23 Typical High $120.23 | Professional | 52 · Reduced service | $93.33 | $120.23 | $120.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $47.86 Typical High $47.86 | Professional | 53 · Discontinued | $37.15 | $47.86 | $47.86 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $36.31 Typical High $36.31 | Professional | 55 · Aftercare only | $27.54 | $36.31 | $36.31 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $23.99 Typical High $23.99 | Professional | 56 · Pre-op care only | $18.62 | $23.99 | $23.99 |
Where Idaho sits
The same service costs 3.5 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· 14th of 51
$245
HI $447DE $129
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.