How much rates vary
Facilitymedian $501 · 10th to 90th $302 to $832Professionalmedian $427 · 10th to 90th $204 to $646
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 $331.13 Median $426.58 Typical High $426.58 | Professional | None | $331.13 | $426.58 | $426.58 |
BCBS Idaho Setting Facility Modifier None Typical Low $407.38 Median $501.19 Typical High $831.76 | Facility | None | $407.38 | $501.19 | $831.76 |
BCBS Idaho Setting Professional Modifier None Typical Low $363.08 Median $549.54 Typical High $575.44 | Professional | None | $363.08 | $549.54 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $316.23 | Facility | None | $302.00 | $302.00 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $302.00 | Professional | None | $218.78 | $218.78 | $302.00 |
Moda Health Setting Facility Modifier None Typical Low $131.83 Median $426.58 Typical High $512.86 | Facility | None | $131.83 | $426.58 | $512.86 |
Moda Health Setting Professional Modifier None Typical Low $331.13 Median $467.74 Typical High $549.54 | Professional | None | $331.13 | $467.74 | $549.54 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $371.54 Typical High $436.52 | Professional | None | $30.20 | $371.54 | $436.52 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $346.74 Median $645.65 Typical High $30,902.95 | Facility | None | $346.74 | $645.65 | $30,902.95 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $512.86 Median $645.65 Typical High $36,307.81 | Professional | None | $512.86 | $645.65 | $36,307.81 |
Regence BlueShield Setting Facility Modifier None Typical Low $478.63 Median $501.19 Typical High $741.31 | Facility | None | $478.63 | $501.19 | $741.31 |
Regence BlueShield Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $549.54 | Professional | None | $363.08 | $363.08 | $549.54 |
Select Health Setting Facility Modifier None Typical Low $478.63 Median $512.86 Typical High $660.69 | Facility | None | $478.63 | $512.86 | $660.69 |
Select Health Setting Professional Modifier None Typical Low $338.84 Median $512.86 Typical High $562.34 | Professional | None | $338.84 | $512.86 | $562.34 |
United Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
United Setting Professional Modifier None Typical Low $186.21 Median $204.17 Typical High $316.23 | Professional | None | $186.21 | $204.17 | $316.23 |
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 $165.96 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $165.96 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $85.11 Typical High $85.11 | Professional | 53 · Discontinued | $66.07 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $48.98 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $42.66 Typical High $42.66 | Professional | 56 · Pre-op care only | $33.11 | $42.66 | $42.66 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $380.19 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $338.84 | $380.19 | $398.11 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $165.96 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $165.96 | $213.80 | $213.80 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $85.11 Typical High $85.11 | Professional | 53 · Discontinued | $66.07 | $85.11 | $85.11 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $48.98 | $64.57 | $64.57 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $42.66 Typical High $42.66 | Professional | 56 · Pre-op care only | $33.11 | $42.66 | $42.66 |
Where Idaho sits
The same service costs 2.5 times more in Hawaii than in Pennsylvania. 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· 9th of 51
$437
HI $550PA $219
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.