How much rates vary
Facilitymedian $1,413 · 10th to 90th $832 to $2,344Professionalmedian $1,259 · 10th to 90th $617 to $1,820
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 $870.96 Median $1,258.93 Typical High $1,258.93 | Professional | None | $870.96 | $1,258.93 | $1,258.93 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $2,344.23 | Facility | None | $1,047.13 | $1,412.54 | $2,344.23 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,023.29 Median $1,548.82 Typical High $1,621.81 | Professional | None | $1,023.29 | $1,548.82 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $933.25 | Facility | None | $831.76 | $831.76 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $831.76 | Professional | None | $616.60 | $616.60 | $831.76 |
Moda Health Setting Facility Modifier None Typical Low $407.38 Median $1,258.93 Typical High $1,479.11 | Facility | None | $407.38 | $1,258.93 | $1,479.11 |
Moda Health Setting Professional Modifier None Typical Low $977.24 Median $1,380.38 Typical High $1,548.82 | Professional | None | $977.24 | $1,380.38 | $1,548.82 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $1,047.13 Typical High $1,230.27 | Professional | None | $30.20 | $1,047.13 | $1,230.27 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $1,023.29 Median $1,819.70 Typical High $89,125.09 | Facility | None | $1,023.29 | $1,819.70 | $89,125.09 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,548.82 Median $1,819.70 Typical High $102,329.30 | Professional | None | $1,548.82 | $1,819.70 | $102,329.30 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,380.38 Median $1,412.54 Typical High $2,089.30 | Facility | None | $1,380.38 | $1,412.54 | $2,089.30 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,548.82 | Professional | None | $1,023.29 | $1,023.29 | $1,548.82 |
Select Health Setting Facility Modifier None Typical Low $1,348.96 Median $1,479.11 Typical High $1,905.46 | Facility | None | $1,348.96 | $1,479.11 | $1,905.46 |
Select Health Setting Professional Modifier None Typical Low $954.99 Median $1,479.11 Typical High $1,621.81 | Professional | None | $954.99 | $1,479.11 | $1,621.81 |
United Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $794.33 | Facility | None | $630.96 | $630.96 | $794.33 |
United Setting Professional Modifier None Typical Low $575.44 Median $630.96 Typical High $933.25 | Professional | None | $575.44 | $630.96 | $933.25 |
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 $489.78 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $489.78 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $194.98 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $144.54 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $97.72 | $125.89 | $125.89 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,071.52 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $954.99 | $1,071.52 | $1,122.02 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $489.78 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $489.78 | $630.96 | $630.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $194.98 | $251.19 | $251.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $144.54 | $190.55 | $190.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $97.72 | $125.89 | $125.89 |
Where Idaho sits
The same service costs 3.2 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· 7th of 51
$1,259
HI $1,950DE $617
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.