How much rates vary
Facilitymedian $339 · 10th to 90th $209 to $13,804Professionalmedian $309 · 10th to 90th $170 to $468
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 $309.03 Typical High $309.03 | Professional | None | $239.88 | $309.03 | $309.03 |
BCBS Idaho Setting Facility Modifier None Typical Low $316.23 Median $380.19 Typical High $616.60 | Facility | None | $316.23 | $380.19 | $616.60 |
BCBS Idaho Setting Professional Modifier None Typical Low $263.03 Median $398.11 Typical High $416.87 | Professional | None | $263.03 | $398.11 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $316.23 | Facility | None | $302.00 | $302.00 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $302.00 | Professional | None | $257.04 | $257.04 | $302.00 |
Moda Health Setting Facility Modifier None Typical Low $109.65 Median $309.03 Typical High $380.19 | Facility | None | $109.65 | $309.03 | $380.19 |
Moda Health Setting Professional Modifier None Typical Low $239.88 Median $338.84 Typical High $398.11 | Professional | None | $239.88 | $338.84 | $398.11 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $269.15 Typical High $316.23 | Professional | None | $30.20 | $269.15 | $316.23 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $295.12 Median $467.74 Typical High $22,387.21 | Facility | None | $295.12 | $467.74 | $22,387.21 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $380.19 Median $467.74 Typical High $26,302.68 | Professional | None | $380.19 | $467.74 | $26,302.68 |
Regence BlueShield Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $398.11 | Professional | None | $263.03 | $263.03 | $398.11 |
Select Health Setting Facility Modifier None Typical Low $371.54 Median $380.19 Typical High $380.19 | Facility | None | $371.54 | $380.19 | $380.19 |
Select Health Setting Professional Modifier None Typical Low $245.47 Median $380.19 Typical High $407.38 | Professional | None | $245.47 | $380.19 | $407.38 |
United Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
United Setting Professional Modifier None Typical Low $158.49 Median $169.82 Typical High $263.03 | Professional | None | $158.49 | $169.82 | $263.03 |
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 $120.23 Median $154.88 Typical High $154.88 | Professional | 52 · Reduced service | $120.23 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $61.66 Typical High $61.66 | Professional | 53 · Discontinued | $47.86 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $46.77 Typical High $46.77 | Professional | 55 · Aftercare only | $36.31 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $30.90 Typical High $30.90 | Professional | 56 · Pre-op care only | $23.99 | $30.90 | $30.90 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $275.42 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $245.47 | $275.42 | $288.40 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $120.23 Median $154.88 Typical High $154.88 | Professional | 52 · Reduced service | $120.23 | $154.88 | $154.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $61.66 Typical High $61.66 | Professional | 53 · Discontinued | $47.86 | $61.66 | $61.66 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $46.77 Typical High $46.77 | Professional | 55 · Aftercare only | $36.31 | $46.77 | $46.77 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $30.90 Typical High $30.90 | Professional | 56 · Pre-op care only | $23.99 | $30.90 | $30.90 |
Where Idaho sits
The same service costs 3.0 times more in Iowa 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· 10th of 51
$309
IA $457NY $151
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.