How much rates vary
Facilitymedian $4,677 · 10th to 90th $2,754 to $7,943Professionalmedian $4,074 · 10th to 90th $1,995 to $6,166
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 $3,162.28 Median $4,073.80 Typical High $4,073.80 | Professional | None | $3,162.28 | $4,073.80 | $4,073.80 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,890.45 Median $4,786.30 Typical High $7,943.28 | Facility | None | $3,890.45 | $4,786.30 | $7,943.28 |
BCBS Idaho Setting Professional Modifier None Typical Low $3,467.37 Median $5,248.07 Typical High $5,495.41 | Professional | None | $3,467.37 | $5,248.07 | $5,495.41 |
Cigna Setting Facility Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $3,019.95 | Facility | None | $2,754.23 | $2,754.23 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,754.23 | Professional | None | $1,995.26 | $1,995.26 | $2,754.23 |
Moda Health Setting Facility Modifier None Typical Low $1,288.25 Median $4,073.80 Typical High $5,011.87 | Facility | None | $1,288.25 | $4,073.80 | $5,011.87 |
Moda Health Setting Professional Modifier None Typical Low $3,162.28 Median $4,466.84 Typical High $5,248.07 | Professional | None | $3,162.28 | $4,466.84 | $5,248.07 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $3,630.78 Typical High $4,265.80 | Professional | None | $30.20 | $3,630.78 | $4,265.80 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $3,162.28 Median $6,165.95 Typical High $301,995.17 | Facility | None | $3,162.28 | $6,165.95 | $301,995.17 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $5,011.87 Median $6,165.95 Typical High $354,813.39 | Professional | None | $5,011.87 | $6,165.95 | $354,813.39 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,677.35 Median $4,786.30 Typical High $7,244.36 | Facility | None | $4,677.35 | $4,786.30 | $7,244.36 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $5,248.07 | Professional | None | $3,467.37 | $3,467.37 | $5,248.07 |
Select Health Setting Facility Modifier None Typical Low $4,570.88 Median $5,011.87 Typical High $6,456.54 | Facility | None | $4,570.88 | $5,011.87 | $6,456.54 |
Select Health Setting Professional Modifier None Typical Low $3,235.94 Median $5,011.87 Typical High $5,248.07 | Professional | None | $3,235.94 | $5,011.87 | $5,248.07 |
United Setting Facility Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,398.83 | Facility | None | $2,187.76 | $2,187.76 | $2,398.83 |
United Setting Professional Modifier None Typical Low $1,819.70 Median $1,995.26 Typical High $3,019.95 | Professional | None | $1,819.70 | $1,995.26 | $3,019.95 |
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 $1,584.89 Median $2,041.74 Typical High $2,041.74 | Professional | 52 · Reduced service | $1,584.89 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $630.96 Median $812.83 Typical High $812.83 | Professional | 53 · Discontinued | $630.96 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $478.63 Median $616.60 Typical High $616.60 | Professional | 55 · Aftercare only | $478.63 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $316.23 Median $407.38 Typical High $407.38 | Professional | 56 · Pre-op care only | $316.23 | $407.38 | $407.38 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,235.94 Median $3,630.78 Typical High $3,801.89 | Professional | 78 · Unplanned return to OR | $3,235.94 | $3,630.78 | $3,801.89 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,584.89 Median $2,041.74 Typical High $2,041.74 | Professional | 52 · Reduced service | $1,584.89 | $2,041.74 | $2,041.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $630.96 Median $812.83 Typical High $812.83 | Professional | 53 · Discontinued | $630.96 | $812.83 | $812.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $478.63 Median $616.60 Typical High $616.60 | Professional | 55 · Aftercare only | $478.63 | $616.60 | $616.60 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $316.23 Median $407.38 Typical High $407.38 | Professional | 56 · Pre-op care only | $316.23 | $407.38 | $407.38 |
Where Idaho sits
The same service costs 2.6 times more in Hawaii than in West Virginia. 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
$4,074
HI $5,129WV $1,995
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.