How much rates vary
Facilitymedian $955 · 10th to 90th $490 to $1,585Professionalmedian $871 · 10th to 90th $363 to $1,259
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 $660.69 Median $870.96 Typical High $870.96 | Professional | None | $660.69 | $870.96 | $870.96 |
BCBS Idaho Setting Facility Modifier None Typical Low $724.44 Median $954.99 Typical High $1,584.89 | Facility | None | $724.44 | $954.99 | $1,584.89 |
BCBS Idaho Setting Professional Modifier None Typical Low $707.95 Median $1,047.13 Typical High $1,096.48 | Professional | None | $707.95 | $1,047.13 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $549.54 | Facility | None | $489.78 | $489.78 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $489.78 | Professional | None | $363.08 | $363.08 | $489.78 |
Moda Health Setting Facility Modifier None Typical Low $257.04 Median $870.96 Typical High $1,000.00 | Facility | None | $257.04 | $870.96 | $1,000.00 |
Moda Health Setting Professional Modifier None Typical Low $660.69 Median $912.01 Typical High $1,047.13 | Professional | None | $660.69 | $912.01 | $1,047.13 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $724.44 Typical High $851.14 | Professional | None | $30.20 | $724.44 | $851.14 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $630.96 Median $1,258.93 Typical High $60,255.96 | Facility | None | $630.96 | $1,258.93 | $60,255.96 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,000.00 Median $1,258.93 Typical High $70,794.58 | Professional | None | $1,000.00 | $1,258.93 | $70,794.58 |
Regence BlueShield Setting Facility Modifier None Typical Low $933.25 Median $954.99 Typical High $1,445.44 | Facility | None | $933.25 | $954.99 | $1,445.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $1,047.13 | Professional | None | $707.95 | $707.95 | $1,047.13 |
Select Health Setting Facility Modifier None Typical Low $933.25 Median $1,000.00 Typical High $1,288.25 | Facility | None | $933.25 | $1,000.00 | $1,288.25 |
Select Health Setting Professional Modifier None Typical Low $645.65 Median $1,000.00 Typical High $1,047.13 | Professional | None | $645.65 | $1,000.00 | $1,047.13 |
United Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $524.81 | Facility | None | $478.63 | $478.63 | $524.81 |
United Setting Professional Modifier None Typical Low $363.08 Median $398.11 Typical High $588.84 | Professional | None | $363.08 | $398.11 | $588.84 |
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 $331.13 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $331.13 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $131.83 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $100.00 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $66.07 | $87.10 | $87.10 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $741.31 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $660.69 | $741.31 | $776.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $331.13 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $331.13 | $426.58 | $426.58 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $131.83 | $173.78 | $173.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $100.00 | $128.82 | $128.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $66.07 | $87.10 | $87.10 |
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· 4th of 51
$871
HI $1,175DE $363
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.