How much rates vary
Facilitymedian $646 · 10th to 90th $372 to $2,344Professionalmedian $562 · 10th to 90th $302 to $851
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 $436.52 Median $562.34 Typical High $562.34 | Professional | None | $436.52 | $562.34 | $562.34 |
BCBS Idaho Setting Facility Modifier None Typical Low $575.44 Median $691.83 Typical High $1,148.15 | Facility | None | $575.44 | $691.83 | $1,148.15 |
BCBS Idaho Setting Professional Modifier None Typical Low $478.63 Median $707.95 Typical High $741.31 | Professional | None | $478.63 | $707.95 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $398.11 | Facility | None | $371.54 | $371.54 | $398.11 |
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 $194.98 Median $562.34 Typical High $645.65 | Facility | None | $194.98 | $562.34 | $645.65 |
Moda Health Setting Professional Modifier None Typical Low $436.52 Median $616.60 Typical High $707.95 | Professional | None | $436.52 | $616.60 | $707.95 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $489.78 Typical High $575.44 | Professional | None | $30.20 | $489.78 | $575.44 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $537.03 Median $851.14 Typical High $40,738.03 | Facility | None | $537.03 | $851.14 | $40,738.03 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $707.95 Median $851.14 Typical High $47,863.01 | Professional | None | $707.95 | $851.14 | $47,863.01 |
Regence BlueShield Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $707.95 | Professional | None | $478.63 | $478.63 | $707.95 |
Select Health Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $691.83 | Facility | None | $676.08 | $676.08 | $691.83 |
Select Health Setting Professional Modifier None Typical Low $446.68 Median $676.08 Typical High $741.31 | Professional | None | $446.68 | $676.08 | $741.31 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
United Setting Professional Modifier None Typical Low $275.42 Median $302.00 Typical High $457.09 | Professional | None | $275.42 | $302.00 | $457.09 |
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 $218.78 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $218.78 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $87.10 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $85.11 Typical High $85.11 | Professional | 55 · Aftercare only | $64.57 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $43.65 | $56.23 | $56.23 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $501.19 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $446.68 | $501.19 | $524.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $218.78 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $218.78 | $281.84 | $281.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $87.10 | $112.20 | $112.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $85.11 Typical High $85.11 | Professional | 55 · Aftercare only | $64.57 | $85.11 | $85.11 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $43.65 | $56.23 | $56.23 |
Where Idaho sits
The same service costs 2.6 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· 11th of 51
$562
MT $708NY $275
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.