How much rates vary
Facilitymedian $7,943 · 10th to 90th $4,677 to $13,183Professionalmedian $6,918 · 10th to 90th $3,020 to $10,471
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 $5,248.07 Median $6,918.31 Typical High $6,918.31 | Professional | None | $5,248.07 | $6,918.31 | $6,918.31 |
BCBS Idaho Setting Facility Modifier None Typical Low $5,888.44 Median $7,943.28 Typical High $13,182.57 | Facility | None | $5,888.44 | $7,943.28 | $13,182.57 |
BCBS Idaho Setting Professional Modifier None Typical Low $5,754.40 Median $8,709.64 Typical High $9,120.11 | Professional | None | $5,754.40 | $8,709.64 | $9,120.11 |
Cigna Setting Facility Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $5,011.87 | Facility | None | $4,677.35 | $4,677.35 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $4,677.35 | Professional | None | $3,467.37 | $3,467.37 | $4,677.35 |
Moda Health Setting Facility Modifier None Typical Low $1,949.84 Median $6,918.31 Typical High $8,317.64 | Facility | None | $1,949.84 | $6,918.31 | $8,317.64 |
Moda Health Setting Professional Modifier None Typical Low $5,248.07 Median $7,413.10 Typical High $8,709.64 | Professional | None | $5,248.07 | $7,413.10 | $8,709.64 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $6,025.60 Typical High $7,079.46 | Professional | None | $30.20 | $6,025.60 | $7,079.46 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $6,456.54 Median $10,471.29 Typical High $501,187.23 | Facility | None | $6,456.54 | $10,471.29 | $501,187.23 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $8,317.64 Median $10,471.29 Typical High $588,843.66 | Professional | None | $8,317.64 | $10,471.29 | $588,843.66 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,762.47 Median $7,943.28 Typical High $12,022.64 | Facility | None | $7,762.47 | $7,943.28 | $12,022.64 |
Regence BlueShield Setting Professional Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $8,709.64 | Professional | None | $5,754.40 | $5,754.40 | $8,709.64 |
Select Health Setting Facility Modifier None Typical Low $8,317.64 Median $8,317.64 Typical High $10,715.19 | Facility | None | $8,317.64 | $8,317.64 | $10,715.19 |
Select Health Setting Professional Modifier None Typical Low $5,370.32 Median $8,317.64 Typical High $9,120.11 | Professional | None | $5,370.32 | $8,317.64 | $9,120.11 |
United Setting Facility Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $4,897.79 | Facility | None | $4,073.80 | $4,073.80 | $4,897.79 |
United Setting Professional Modifier None Typical Low $2,818.38 Median $3,019.95 Typical High $4,677.35 | Professional | None | $2,818.38 | $3,019.95 | $4,677.35 |
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 $2,630.27 Median $3,388.44 Typical High $3,388.44 | Professional | 52 · Reduced service | $2,630.27 | $3,388.44 | $3,388.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,047.13 Median $1,380.38 Typical High $1,380.38 | Professional | 53 · Discontinued | $1,047.13 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $794.33 Median $1,023.29 Typical High $1,023.29 | Professional | 55 · Aftercare only | $794.33 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $524.81 Median $691.83 Typical High $691.83 | Professional | 56 · Pre-op care only | $524.81 | $691.83 | $691.83 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $5,495.41 Median $6,165.95 Typical High $6,456.54 | Professional | 78 · Unplanned return to OR | $5,495.41 | $6,165.95 | $6,456.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2,630.27 Median $3,388.44 Typical High $3,388.44 | Professional | 52 · Reduced service | $2,630.27 | $3,388.44 | $3,388.44 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1,047.13 Median $1,380.38 Typical High $1,380.38 | Professional | 53 · Discontinued | $1,047.13 | $1,380.38 | $1,380.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $794.33 Median $1,023.29 Typical High $1,023.29 | Professional | 55 · Aftercare only | $794.33 | $1,023.29 | $1,023.29 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $524.81 Median $691.83 Typical High $691.83 | Professional | 56 · Pre-op care only | $524.81 | $691.83 | $691.83 |
Where Idaho sits
The same service costs 3.9 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· 11th of 51
$6,918
HI $12,882DC $3,311
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.