How much rates vary
Facilitymedian $5,012 · 10th to 90th $3,020 to $8,511Professionalmedian $4,467 · 10th to 90th $1,995 to $6,761
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 $3,467.37 Median $4,466.84 Typical High $4,466.84 | Professional | None | $3,467.37 | $4,466.84 | $4,466.84 |
BCBS Idaho Setting Facility Modifier None Typical Low $4,168.69 Median $5,011.87 Typical High $8,511.38 | Facility | None | $4,168.69 | $5,011.87 | $8,511.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $3,801.89 Median $5,623.41 Typical High $5,888.44 | Professional | None | $3,801.89 | $5,623.41 | $5,888.44 |
Cigna Setting Facility Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,162.28 | Facility | None | $3,019.95 | $3,019.95 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $3,019.95 | Professional | None | $2,187.76 | $2,187.76 | $3,019.95 |
Moda Health Setting Facility Modifier None Typical Low $2,884.03 Median $4,466.84 Typical High $5,370.32 | Facility | None | $2,884.03 | $4,466.84 | $5,370.32 |
Moda Health Setting Professional Modifier None Typical Low $3,467.37 Median $4,897.79 Typical High $5,623.41 | Professional | None | $3,467.37 | $4,897.79 | $5,623.41 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $3,890.45 Typical High $4,570.88 | Professional | None | $30.20 | $3,890.45 | $4,570.88 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $3,548.13 Median $6,760.83 Typical High $323,593.66 | Facility | None | $3,548.13 | $6,760.83 | $323,593.66 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $5,370.32 Median $6,760.83 Typical High $380,189.40 | Professional | None | $5,370.32 | $6,760.83 | $380,189.40 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,011.87 Median $5,128.61 Typical High $7,762.47 | Facility | None | $5,011.87 | $5,128.61 | $7,762.47 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $5,623.41 | Professional | None | $3,801.89 | $3,801.89 | $5,623.41 |
Select Health Setting Facility Modifier None Typical Low $4,466.84 Median $5,370.32 Typical High $5,495.41 | Facility | None | $4,466.84 | $5,370.32 | $5,495.41 |
Select Health Setting Professional Modifier None Typical Low $3,467.37 Median $5,370.32 Typical High $5,754.40 | Professional | None | $3,467.37 | $5,370.32 | $5,754.40 |
United Setting Professional Modifier None Typical Low $1,819.70 Median $1,995.26 Typical High $3,162.28 | Professional | None | $1,819.70 | $1,995.26 | $3,162.28 |
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 $1,698.24 Median $2,238.72 Typical High $2,238.72 | Professional | 52 · Reduced service | $1,698.24 | $2,238.72 | $2,238.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $691.83 Median $891.25 Typical High $891.25 | Professional | 53 · Discontinued | $691.83 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $512.86 Median $660.69 Typical High $660.69 | Professional | 55 · Aftercare only | $512.86 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $346.74 Median $446.68 Typical High $446.68 | Professional | 56 · Pre-op care only | $346.74 | $446.68 | $446.68 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,548.13 Median $3,981.07 Typical High $4,168.69 | Professional | 78 · Unplanned return to OR | $3,548.13 | $3,981.07 | $4,168.69 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,698.24 Median $2,238.72 Typical High $2,238.72 | Professional | 52 · Reduced service | $1,698.24 | $2,238.72 | $2,238.72 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $691.83 Median $891.25 Typical High $891.25 | Professional | 53 · Discontinued | $691.83 | $891.25 | $891.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $512.86 Median $660.69 Typical High $660.69 | Professional | 55 · Aftercare only | $512.86 | $660.69 | $660.69 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $346.74 Median $446.68 Typical High $446.68 | Professional | 56 · Pre-op care only | $346.74 | $446.68 | $446.68 |
Where Idaho sits
The same service costs 2.4 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· 8th of 51
$4,467
HI $5,248WV $2,188
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.