How much rates vary
Facilitymedian $1,047 · 10th to 90th $479 to $31,623Professionalmedian $891 · 10th to 90th $389 to $1,514
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 $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
BCBS Idaho Setting Facility Modifier None Typical Low $6.31 Median $1,096.48 Typical High $1,348.96 | Facility | None | $6.31 | $1,096.48 | $1,348.96 |
BCBS Idaho Setting Professional Modifier None Typical Low $602.56 Median $912.01 Typical High $954.99 | Professional | None | $602.56 | $912.01 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $501.19 | Facility | None | $478.63 | $478.63 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $478.63 | Professional | None | $407.38 | $407.38 | $478.63 |
Moda Health Setting Facility Modifier None Typical Low $812.83 Median $1,513.56 Typical High $1,513.56 | Facility | None | $812.83 | $1,513.56 | $1,513.56 |
Moda Health Setting Professional Modifier None Typical Low $812.83 Median $912.01 Typical High $1,513.56 | Professional | None | $812.83 | $912.01 | $1,513.56 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $616.60 Typical High $724.44 | Professional | None | $30.20 | $616.60 | $724.44 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $851.14 Median $1,071.52 Typical High $51,286.14 | Facility | None | $851.14 | $1,071.52 | $51,286.14 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $60,255.96 | Professional | None | $912.01 | $1,071.52 | $60,255.96 |
Regence BlueShield Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $912.01 | Professional | None | $602.56 | $602.56 | $912.01 |
Select Health Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $891.25 | Facility | None | $851.14 | $851.14 | $891.25 |
Select Health Setting Professional Modifier None Typical Low $562.34 Median $851.14 Typical High $933.25 | Professional | None | $562.34 | $851.14 | $933.25 |
United Setting Professional Modifier None Typical Low $363.08 Median $389.05 Typical High $616.60 | Professional | None | $363.08 | $389.05 | $616.60 |
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 $741.31 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $741.31 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $302.00 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $223.87 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $151.36 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $630.96 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $562.34 | $630.96 | $660.69 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $741.31 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $741.31 | $758.58 | $758.58 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $302.00 | $302.00 | $302.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $223.87 | $229.09 | $229.09 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $151.36 |
Where Idaho sits
The same service costs 3.2 times more in Michigan than in Ohio. 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· 10th of 51
$891
MI $1,413OH $447
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.