How much rates vary
Facilitymedian $309 · 10th to 90th $170 to $525Professionalmedian $269 · 10th to 90th $126 to $407
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 $208.93 Median $269.15 Typical High $269.15 | Professional | None | $208.93 | $269.15 | $269.15 |
BCBS Idaho Setting Facility Modifier None Typical Low $251.19 Median $309.03 Typical High $524.81 | Facility | None | $251.19 | $309.03 | $524.81 |
BCBS Idaho Setting Professional Modifier None Typical Low $229.09 Median $338.84 Typical High $354.81 | Professional | None | $229.09 | $338.84 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $181.97 | Facility | None | $169.82 | $169.82 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $169.82 | Professional | None | $125.89 | $125.89 | $169.82 |
Moda Health Setting Facility Modifier None Typical Low $87.10 Median $269.15 Typical High $323.59 | Facility | None | $87.10 | $269.15 | $323.59 |
Moda Health Setting Professional Modifier None Typical Low $208.93 Median $295.12 Typical High $338.84 | Professional | None | $208.93 | $295.12 | $338.84 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $218.78 Median $407.38 Typical High $19,498.45 | Facility | None | $218.78 | $407.38 | $19,498.45 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $323.59 Median $407.38 Typical High $22,908.68 | Professional | None | $323.59 | $407.38 | $22,908.68 |
Regence BlueShield Setting Facility Modifier None Typical Low $302.00 Median $309.03 Typical High $467.74 | Facility | None | $302.00 | $309.03 | $467.74 |
Regence BlueShield Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $338.84 | Professional | None | $229.09 | $229.09 | $338.84 |
Select Health Setting Facility Modifier None Typical Low $302.00 Median $323.59 Typical High $416.87 | Facility | None | $302.00 | $323.59 | $416.87 |
Select Health Setting Professional Modifier None Typical Low $208.93 Median $323.59 Typical High $354.81 | Professional | None | $208.93 | $323.59 | $354.81 |
United Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
United Setting Professional Modifier None Typical Low $125.89 Median $134.90 Typical High $208.93 | Professional | None | $125.89 | $134.90 | $208.93 |
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 $102.33 Median $134.90 Typical High $134.90 | Professional | 52 · Reduced service | $102.33 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $53.70 Typical High $53.70 | Professional | 53 · Discontinued | $41.69 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $39.81 Typical High $39.81 | Professional | 55 · Aftercare only | $30.90 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $26.92 Typical High $26.92 | Professional | 56 · Pre-op care only | $20.89 | $26.92 | $26.92 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $239.88 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $213.80 | $239.88 | $251.19 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $102.33 Median $134.90 Typical High $134.90 | Professional | 52 · Reduced service | $102.33 | $134.90 | $134.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $53.70 Typical High $53.70 | Professional | 53 · Discontinued | $41.69 | $53.70 | $53.70 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $39.81 Typical High $39.81 | Professional | 55 · Aftercare only | $30.90 | $39.81 | $39.81 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $26.92 Typical High $26.92 | Professional | 56 · Pre-op care only | $20.89 | $26.92 | $26.92 |
Where Idaho sits
The same service costs 2.4 times more in Hawaii than in Florida. 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
$275
HI $324FL $135
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.