How much rates vary
Facilitymedian $794 · 10th to 90th $398 to $1,349Professionalmedian $676 · 10th to 90th $295 to $1,023
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 $524.81 Median $676.08 Typical High $676.08 | Professional | None | $524.81 | $676.08 | $676.08 |
BCBS Idaho Setting Facility Modifier None Typical Low $645.65 Median $794.33 Typical High $1,348.96 | Facility | None | $645.65 | $794.33 | $1,348.96 |
BCBS Idaho Setting Professional Modifier None Typical Low $575.44 Median $870.96 Typical High $912.01 | Professional | None | $575.44 | $870.96 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $426.58 | Facility | None | $398.11 | $398.11 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $398.11 | Professional | None | $295.12 | $295.12 | $398.11 |
Moda Health Setting Facility Modifier None Typical Low $208.93 Median $676.08 Typical High $831.76 | Facility | None | $208.93 | $676.08 | $831.76 |
Moda Health Setting Professional Modifier None Typical Low $524.81 Median $741.31 Typical High $870.96 | Professional | None | $524.81 | $741.31 | $870.96 |
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 $524.81 Median $1,023.29 Typical High $48,977.88 | Facility | None | $524.81 | $1,023.29 | $48,977.88 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $831.76 Median $1,023.29 Typical High $57,543.99 | Professional | None | $831.76 | $1,023.29 | $57,543.99 |
Regence BlueShield Setting Facility Modifier None Typical Low $776.25 Median $794.33 Typical High $1,174.90 | Facility | None | $776.25 | $794.33 | $1,174.90 |
Regence BlueShield Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $870.96 | Professional | None | $575.44 | $575.44 | $870.96 |
Select Health Setting Facility Modifier None Typical Low $758.58 Median $831.76 Typical High $1,047.13 | Facility | None | $758.58 | $831.76 | $1,047.13 |
Select Health Setting Professional Modifier None Typical Low $537.03 Median $831.76 Typical High $851.14 | Professional | None | $537.03 | $831.76 | $851.14 |
United Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
United Setting Professional Modifier None Typical Low $295.12 Median $323.59 Typical High $489.78 | Professional | None | $295.12 | $323.59 | $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 $263.03 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $263.03 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $104.71 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $79.43 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $52.48 | $67.61 | $67.61 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $602.56 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $537.03 | $602.56 | $630.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $263.03 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $263.03 | $338.84 | $338.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $104.71 | $134.90 | $134.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $79.43 | $102.33 | $102.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $52.48 | $67.61 | $67.61 |
Where Idaho sits
The same service costs 2.8 times more in Wisconsin 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· 9th of 51
$692
WI $851FL $309
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.