How much rates vary
Facilitymedian $1,585 · 10th to 90th $933 to $2,692Professionalmedian $1,445 · 10th to 90th $692 to $2,089
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 $1,122.02 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,122.02 | $1,445.44 | $1,445.44 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,202.26 Median $1,621.81 Typical High $2,691.53 | Facility | None | $1,202.26 | $1,621.81 | $2,691.53 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,174.90 Median $1,778.28 Typical High $1,862.09 | Professional | None | $1,174.90 | $1,778.28 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $1,000.00 | Facility | None | $933.25 | $933.25 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $933.25 | Professional | None | $691.83 | $691.83 | $933.25 |
Moda Health Setting Facility Modifier None Typical Low $489.78 Median $1,445.44 Typical High $1,698.24 | Facility | None | $489.78 | $1,445.44 | $1,698.24 |
Moda Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,513.56 Typical High $1,778.28 | Professional | None | $1,122.02 | $1,513.56 | $1,778.28 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $1,258.93 Typical High $1,445.44 | Professional | None | $30.20 | $1,258.93 | $1,445.44 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $1,348.96 Median $2,089.30 Typical High $100,000.00 | Facility | None | $1,348.96 | $2,089.30 | $100,000.00 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,778.28 Median $2,089.30 Typical High $117,489.76 | Professional | None | $1,778.28 | $2,089.30 | $117,489.76 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,548.82 Median $1,621.81 Typical High $2,398.83 | Facility | None | $1,548.82 | $1,621.81 | $2,398.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,778.28 | Professional | None | $1,174.90 | $1,174.90 | $1,778.28 |
Select Health Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $2,137.96 | Facility | None | $1,698.24 | $1,698.24 | $2,137.96 |
Select Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,698.24 Typical High $1,819.70 | Professional | None | $1,096.48 | $1,698.24 | $1,819.70 |
United Setting Professional Modifier None Typical Low $691.83 Median $758.58 Typical High $1,122.02 | Professional | None | $691.83 | $758.58 | $1,122.02 |
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 $549.54 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $549.54 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $223.87 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $165.96 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $112.20 | $144.54 | $144.54 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,230.27 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,230.27 | $1,288.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $549.54 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $549.54 | $724.44 | $724.44 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $223.87 | $288.40 | $288.40 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $165.96 | $213.80 | $213.80 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $112.20 | $144.54 | $144.54 |
Where Idaho sits
The same service costs 2.6 times more in Hawaii than in Delaware. 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· 12th of 51
$1,445
HI $1,778DE $692
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.