How much rates vary
Facilitymedian $372 · 10th to 90th $245 to $617Professionalmedian $316 · 10th to 90th $191 to $479
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 $239.88 Median $316.23 Typical High $316.23 | Professional | None | $239.88 | $316.23 | $316.23 |
BCBS Idaho Setting Facility Modifier None Typical Low $275.42 Median $371.54 Typical High $616.60 | Facility | None | $275.42 | $371.54 | $616.60 |
BCBS Idaho Setting Professional Modifier None Typical Low $269.15 Median $407.38 Typical High $426.58 | Professional | None | $269.15 | $407.38 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $309.03 | Facility | None | $295.12 | $295.12 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $295.12 | Professional | None | $213.80 | $213.80 | $295.12 |
Moda Health Setting Facility Modifier None Typical Low $123.03 Median $316.23 Typical High $389.05 | Facility | None | $123.03 | $316.23 | $389.05 |
Moda Health Setting Professional Modifier None Typical Low $245.47 Median $316.23 Typical High $407.38 | Professional | None | $245.47 | $316.23 | $407.38 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $275.42 Typical High $323.59 | Professional | None | $30.20 | $275.42 | $323.59 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $309.03 Median $478.63 Typical High $22,908.68 | Facility | None | $309.03 | $478.63 | $22,908.68 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $26,915.35 | Professional | None | $407.38 | $478.63 | $26,915.35 |
Regence BlueShield Setting Facility Modifier None Typical Low $363.08 Median $371.54 Typical High $549.54 | Facility | None | $363.08 | $371.54 | $549.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $407.38 | Professional | None | $269.15 | $269.15 | $407.38 |
Select Health Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $489.78 | Facility | None | $389.05 | $389.05 | $489.78 |
Select Health Setting Professional Modifier None Typical Low $251.19 Median $389.05 Typical High $426.58 | Professional | None | $251.19 | $389.05 | $426.58 |
United Setting Facility Modifier None Typical Low $186.21 Median $229.09 Typical High $251.19 | Facility | None | $186.21 | $229.09 | $251.19 |
United Setting Professional Modifier None Typical Low $173.78 Median $190.55 Typical High $295.12 | Professional | None | $173.78 | $190.55 | $295.12 |
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 $123.03 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $123.03 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $48.98 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $47.86 Typical High $47.86 | Professional | 55 · Aftercare only | $37.15 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $24.55 | $31.62 | $31.62 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $281.84 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $251.19 | $281.84 | $295.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $123.03 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $123.03 | $158.49 | $158.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $48.98 | $63.10 | $63.10 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $47.86 Typical High $47.86 | Professional | 55 · Aftercare only | $37.15 | $47.86 | $47.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $24.55 | $31.62 | $31.62 |
Where Idaho sits
The same service costs 2.5 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· 16th of 51
$324
HI $513DC $209
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.