How much rates vary
Facilitymedian $1,148 · 10th to 90th $676 to $1,950Professionalmedian $1,047 · 10th to 90th $513 to $1,514
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 $812.83 Median $1,047.13 Typical High $1,047.13 | Professional | None | $812.83 | $1,047.13 | $1,047.13 |
BCBS Idaho Setting Facility Modifier None Typical Low $870.96 Median $1,174.90 Typical High $1,949.84 | Facility | None | $870.96 | $1,174.90 | $1,949.84 |
BCBS Idaho Setting Professional Modifier None Typical Low $851.14 Median $1,288.25 Typical High $1,348.96 | Professional | None | $851.14 | $1,288.25 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $776.25 | Facility | None | $741.31 | $741.31 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $741.31 | Professional | None | $537.03 | $537.03 | $741.31 |
Moda Health Setting Facility Modifier None Typical Low $331.13 Median $1,047.13 Typical High $1,230.27 | Facility | None | $331.13 | $1,047.13 | $1,230.27 |
Moda Health Setting Professional Modifier None Typical Low $812.83 Median $1,096.48 Typical High $1,288.25 | Professional | None | $812.83 | $1,096.48 | $1,288.25 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $870.96 Typical High $1,047.13 | Professional | None | $30.20 | $870.96 | $1,047.13 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $831.76 Median $1,513.56 Typical High $74,131.02 | Facility | None | $831.76 | $1,513.56 | $74,131.02 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,230.27 Median $1,513.56 Typical High $85,113.80 | Professional | None | $1,230.27 | $1,513.56 | $85,113.80 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,148.15 Median $1,174.90 Typical High $1,737.80 | Facility | None | $1,148.15 | $1,174.90 | $1,737.80 |
Regence BlueShield Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,288.25 | Professional | None | $851.14 | $851.14 | $1,288.25 |
Select Health Setting Facility Modifier None Typical Low $1,122.02 Median $1,230.27 Typical High $1,584.89 | Facility | None | $1,122.02 | $1,230.27 | $1,584.89 |
Select Health Setting Professional Modifier None Typical Low $794.33 Median $1,230.27 Typical High $1,348.96 | Professional | None | $794.33 | $1,230.27 | $1,348.96 |
United Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $691.83 | Facility | None | $645.65 | $645.65 | $691.83 |
United Setting Professional Modifier None Typical Low $478.63 Median $512.86 Typical High $776.25 | Professional | None | $478.63 | $512.86 | $776.25 |
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 $407.38 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $407.38 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $162.18 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $120.23 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $81.28 | $104.71 | $104.71 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $891.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $794.33 | $891.25 | $933.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $407.38 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $407.38 | $524.81 | $524.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $162.18 | $208.93 | $208.93 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $120.23 | $158.49 | $158.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $81.28 | $104.71 | $104.71 |
Where Idaho sits
The same service costs 3.0 times more in Hawaii than in Vermont. 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· 9th of 51
$1,047
HI $1,622VT $537
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.