How much rates vary
Facilitymedian $575 · 10th to 90th $501 to $955Professionalmedian $513 · 10th to 90th $219 to $759
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 $380.19 Median $512.86 Typical High $512.86 | Professional | None | $380.19 | $512.86 | $512.86 |
BCBS Idaho Setting Facility Modifier None Typical Low $426.58 Median $575.44 Typical High $954.99 | Facility | None | $426.58 | $575.44 | $954.99 |
BCBS Idaho Setting Professional Modifier None Typical Low $426.58 Median $630.96 Typical High $660.69 | Professional | None | $426.58 | $630.96 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
Moda Health Setting Facility Modifier None Typical Low $478.63 Median $512.86 Typical High $741.31 | Facility | None | $478.63 | $512.86 | $741.31 |
Moda Health Setting Professional Modifier None Typical Low $478.63 Median $512.86 Typical High $630.96 | Professional | None | $478.63 | $512.86 | $630.96 |
Molina Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $407.38 | Professional | None | $346.74 | $346.74 | $407.38 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $36,307.81 | Facility | None | $758.58 | $758.58 | $36,307.81 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $151.36 Median $758.58 Typical High $42,657.95 | Professional | None | $151.36 | $758.58 | $42,657.95 |
Regence BlueShield Setting Facility Modifier None Typical Low $562.34 Median $575.44 Typical High $870.96 | Facility | None | $562.34 | $575.44 | $870.96 |
Regence BlueShield Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $630.96 | Professional | None | $426.58 | $426.58 | $630.96 |
Select Health Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $776.25 | Facility | None | $602.56 | $602.56 | $776.25 |
Select Health Setting Professional Modifier None Typical Low $588.84 Median $602.56 Typical High $1,202.26 | Professional | None | $588.84 | $602.56 | $1,202.26 |
United Setting Professional Modifier None Typical Low $173.78 Median $208.93 Typical High $223.87 | Professional | None | $173.78 | $208.93 | $223.87 |
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 $190.55 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $190.55 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $75.86 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $57.54 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $38.02 | $51.29 | $51.29 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $467.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $239.88 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $239.88 | $257.04 | $257.04 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $97.72 | $104.71 | $104.71 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $72.44 | $77.62 | $77.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $47.86 | $51.29 | $51.29 |
Where Idaho sits
The same service costs 2.8 times more in Montana than in Florida. 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· 6th of 51
$513
MT $603FL $219
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.