How much rates vary
Facilitymedian $4,266 · 10th to 90th $2,455 to $7,079Professionalmedian $3,715 · 10th to 90th $1,660 to $5,623
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 $2,884.03 Median $3,715.35 Typical High $3,715.35 | Professional | None | $2,884.03 | $3,715.35 | $3,715.35 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,467.37 Median $4,265.80 Typical High $7,079.46 | Facility | None | $3,467.37 | $4,265.80 | $7,079.46 |
BCBS Idaho Setting Professional Modifier None Typical Low $3,162.28 Median $4,677.35 Typical High $4,897.79 | Professional | None | $3,162.28 | $4,677.35 | $4,897.79 |
Cigna Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,754.23 | Facility | None | $2,454.71 | $2,454.71 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,454.71 | Professional | None | $1,819.70 | $1,819.70 | $2,454.71 |
Moda Health Setting Facility Modifier None Typical Low $1,071.52 Median $3,715.35 Typical High $4,466.84 | Facility | None | $1,071.52 | $3,715.35 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $2,884.03 Median $4,073.80 Typical High $4,677.35 | Professional | None | $2,884.03 | $4,073.80 | $4,677.35 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $3,235.94 Typical High $3,801.89 | Professional | None | $30.20 | $3,235.94 | $3,801.89 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $2,884.03 Median $5,623.41 Typical High $269,153.48 | Facility | None | $2,884.03 | $5,623.41 | $269,153.48 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $4,466.84 Median $5,623.41 Typical High $316,227.77 | Professional | None | $4,466.84 | $5,623.41 | $316,227.77 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,168.69 Median $4,265.80 Typical High $6,456.54 | Facility | None | $4,168.69 | $4,265.80 | $6,456.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $4,677.35 | Professional | None | $3,162.28 | $3,162.28 | $4,677.35 |
Select Health Setting Facility Modifier None Typical Low $4,168.69 Median $4,466.84 Typical High $5,754.40 | Facility | None | $4,168.69 | $4,466.84 | $5,754.40 |
Select Health Setting Professional Modifier None Typical Low $2,951.21 Median $4,466.84 Typical High $4,786.30 | Professional | None | $2,951.21 | $4,466.84 | $4,786.30 |
United Setting Facility Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,290.87 | Facility | None | $2,187.76 | $2,187.76 | $2,290.87 |
United Setting Professional Modifier None Typical Low $1,513.56 Median $1,659.59 Typical High $2,570.40 | Professional | None | $1,513.56 | $1,659.59 | $2,570.40 |
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 $1,445.44 Median $1,862.09 Typical High $1,862.09 | Professional | 52 · Reduced service | $1,445.44 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $741.31 Typical High $741.31 | Professional | 53 · Discontinued | $575.44 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $426.58 Median $562.34 Typical High $562.34 | Professional | 55 · Aftercare only | $426.58 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $371.54 Typical High $371.54 | Professional | 56 · Pre-op care only | $288.40 | $371.54 | $371.54 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,951.21 Median $3,311.31 Typical High $3,467.37 | Professional | 78 · Unplanned return to OR | $2,951.21 | $3,311.31 | $3,467.37 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,445.44 Median $1,862.09 Typical High $1,862.09 | Professional | 52 · Reduced service | $1,445.44 | $1,862.09 | $1,862.09 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $741.31 Typical High $741.31 | Professional | 53 · Discontinued | $575.44 | $741.31 | $741.31 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $426.58 Median $562.34 Typical High $562.34 | Professional | 55 · Aftercare only | $426.58 | $562.34 | $562.34 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $371.54 Typical High $371.54 | Professional | 56 · Pre-op care only | $288.40 | $371.54 | $371.54 |
Where Idaho sits
The same service costs 3.2 times more in Hawaii than in Washington, DC. 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
$3,715
HI $5,623DC $1,778
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.