How much rates vary
Facilitymedian $219 · 10th to 90th $141 to $372Professionalmedian $186 · 10th to 90th $102 to $282
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 $144.54 Median $186.21 Typical High $186.21 | Professional | None | $144.54 | $186.21 | $186.21 |
BCBS Idaho Setting Facility Modifier None Typical Low $177.83 Median $218.78 Typical High $371.54 | Facility | None | $177.83 | $218.78 | $371.54 |
BCBS Idaho Setting Professional Modifier None Typical Low $158.49 Median $239.88 Typical High $251.19 | Professional | None | $158.49 | $239.88 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $177.83 | Facility | None | $169.82 | $169.82 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $169.82 | Professional | None | $123.03 | $123.03 | $169.82 |
Moda Health Setting Facility Modifier None Typical Low $66.07 Median $186.21 Typical High $229.09 | Facility | None | $66.07 | $186.21 | $229.09 |
Moda Health Setting Professional Modifier None Typical Low $144.54 Median $204.17 Typical High $239.88 | Professional | None | $144.54 | $204.17 | $239.88 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $162.18 Typical High $190.55 | Professional | None | $30.20 | $162.18 | $190.55 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $173.78 Median $281.84 Typical High $13,489.63 | Facility | None | $173.78 | $281.84 | $13,489.63 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $229.09 Median $281.84 Typical High $15,848.93 | Professional | None | $229.09 | $281.84 | $15,848.93 |
Regence BlueShield Setting Facility Modifier None Typical Low $213.80 Median $218.78 Typical High $323.59 | Facility | None | $213.80 | $218.78 | $323.59 |
Regence BlueShield Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $239.88 | Professional | None | $158.49 | $158.49 | $239.88 |
Select Health Setting Facility Modifier None Typical Low $223.87 Median $229.09 Typical High $288.40 | Facility | None | $223.87 | $229.09 | $288.40 |
Select Health Setting Professional Modifier None Typical Low $147.91 Median $229.09 Typical High $251.19 | Professional | None | $147.91 | $229.09 | $251.19 |
United Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $134.90 | Facility | None | $107.15 | $107.15 | $134.90 |
United Setting Professional Modifier None Typical Low $93.33 Median $102.33 Typical High $158.49 | Professional | None | $93.33 | $102.33 | $158.49 |
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 $72.44 Median $93.33 Typical High $93.33 | Professional | 52 · Reduced service | $72.44 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $37.15 Typical High $37.15 | Professional | 53 · Discontinued | $28.84 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $28.18 Typical High $28.18 | Professional | 55 · Aftercare only | $21.88 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $18.62 Typical High $18.62 | Professional | 56 · Pre-op care only | $14.45 | $18.62 | $18.62 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $165.96 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $147.91 | $165.96 | $173.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $72.44 Median $93.33 Typical High $93.33 | Professional | 52 · Reduced service | $72.44 | $93.33 | $93.33 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $37.15 Typical High $37.15 | Professional | 53 · Discontinued | $28.84 | $37.15 | $37.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $28.18 Typical High $28.18 | Professional | 55 · Aftercare only | $21.88 | $28.18 | $28.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $18.62 Typical High $18.62 | Professional | 56 · Pre-op care only | $14.45 | $18.62 | $18.62 |
Where Idaho sits
The same service costs 2.7 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· 12th of 51
$191
HI $295DC $110
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.