How much rates vary
Facilitymedian $1,778 · 10th to 90th $1,259 to $3,236Professionalmedian $1,445 · 10th to 90th $1,259 to $1,549
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 $1,258.93 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,258.93 | $1,548.82 | $1,548.82 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,202.26 Median $1,995.26 Typical High $3,630.78 | Facility | None | $1,202.26 | $1,995.26 | $3,630.78 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,380.38 Median $1,445.44 Typical High $1,513.56 | Professional | None | $1,380.38 | $1,445.44 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $1,778.28 Typical High $3,162.28 | Facility | None | $1,737.80 | $1,778.28 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
Moda Health Setting Facility Modifier None Typical Low $1,258.93 Median $1,548.82 Typical High $1,584.89 | Facility | None | $1,258.93 | $1,548.82 | $1,584.89 |
Moda Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,548.82 Typical High $1,584.89 | Professional | None | $1,258.93 | $1,548.82 | $1,584.89 |
Molina Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,202.26 | Professional | None | $1,023.29 | $1,023.29 | $1,202.26 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $1,380.38 Median $1,445.44 Typical High $1,905.46 | Facility | None | $1,380.38 | $1,445.44 | $1,905.46 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $1,548.82 | Professional | None | $1,258.93 | $1,513.56 | $1,548.82 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,513.56 Median $2,187.76 Typical High $3,715.35 | Facility | None | $1,513.56 | $2,187.76 | $3,715.35 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,380.38 Median $1,513.56 Typical High $1,548.82 | Professional | None | $1,380.38 | $1,513.56 | $1,548.82 |
Select Health Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $2,454.71 | Facility | None | $1,258.93 | $1,258.93 | $2,454.71 |
Select Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,479.11 | Professional | None | $1,258.93 | $1,258.93 | $1,479.11 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,412.54 | Professional | None | $1,258.93 | $1,258.93 | $1,412.54 |
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 $630.96 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $630.96 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $251.19 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $190.55 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $125.89 | $154.88 | $154.88 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $954.99 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $912.01 | $954.99 | $1,000.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $691.83 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $691.83 | $794.33 | $794.33 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $275.42 | $316.23 | $316.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $208.93 | $239.88 | $239.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $138.04 | $158.49 | $158.49 |
Where Idaho sits
Rates are fairly even across states for this service. 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· 7th of 51
$1,445
AK $1,698FL $1,259
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.