How much rates vary
Facilitymedian $513 · 10th to 90th $195 to $20,893Professionalmedian $468 · 10th to 90th $209 to $708
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $363.08 Median $467.74 Typical High $467.74 | Professional | None | $363.08 | $467.74 | $467.74 |
BCBS Idaho Setting Facility Modifier None Typical Low $436.52 Median $812.83 Typical High $933.25 | Facility | None | $436.52 | $812.83 | $933.25 |
BCBS Idaho Setting Professional Modifier None Typical Low $398.11 Median $602.56 Typical High $630.96 | Professional | None | $398.11 | $602.56 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $389.05 | Facility | None | $371.54 | $371.54 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $371.54 | Professional | None | $316.23 | $316.23 | $371.54 |
Moda Health Setting Facility Modifier None Typical Low $134.90 Median $467.74 Typical High $575.44 | Facility | None | $134.90 | $467.74 | $575.44 |
Moda Health Setting Professional Modifier None Typical Low $363.08 Median $512.86 Typical High $602.56 | Professional | None | $363.08 | $512.86 | $602.56 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $407.38 Typical High $478.63 | Professional | None | $30.20 | $407.38 | $478.63 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $446.68 Median $707.95 Typical High $34,673.69 | Facility | None | $446.68 | $707.95 | $34,673.69 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $575.44 Median $707.95 Typical High $39,810.72 | Professional | None | $575.44 | $707.95 | $39,810.72 |
Regence BlueShield Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $602.56 | Professional | None | $398.11 | $398.11 | $602.56 |
Select Health Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $588.84 | Facility | None | $575.44 | $575.44 | $588.84 |
Select Health Setting Professional Modifier None Typical Low $371.54 Median $575.44 Typical High $630.96 | Professional | None | $371.54 | $575.44 | $630.96 |
United Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
United Setting Professional Modifier None Typical Low $194.98 Median $208.93 Typical High $323.59 | Professional | None | $194.98 | $208.93 | $323.59 |
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 $181.97 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $181.97 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $72.44 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $70.79 Typical High $70.79 | Professional | 55 · Aftercare only | $54.95 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $36.31 | $46.77 | $46.77 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $416.87 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $371.54 | $416.87 | $436.52 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $181.97 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $181.97 | $234.42 | $234.42 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $72.44 | $93.33 | $93.33 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $70.79 Typical High $70.79 | Professional | 55 · Aftercare only | $54.95 | $70.79 | $70.79 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $36.31 | $46.77 | $46.77 |
Where Idaho sits
The same service costs 3.4 times more in Montana than in New York. 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· 5th of 51
$468
MT $589NY $174
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.