How much rates vary
Facilitymedian $2,042 · 10th to 90th $1,380 to $3,388Professionalmedian $1,738 · 10th to 90th $1,047 to $2,692
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 $1,348.96 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,348.96 | $1,737.80 | $1,737.80 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,659.59 Median $2,041.74 Typical High $3,388.44 | Facility | None | $1,659.59 | $2,041.74 | $3,388.44 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,479.11 Median $2,238.72 Typical High $2,344.23 | Professional | None | $1,479.11 | $2,238.72 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,737.80 | Facility | None | $1,621.81 | $1,621.81 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,621.81 | Professional | None | $1,174.90 | $1,174.90 | $1,621.81 |
Moda Health Setting Facility Modifier None Typical Low $676.08 Median $1,737.80 Typical High $2,137.96 | Facility | None | $676.08 | $1,737.80 | $2,137.96 |
Moda Health Setting Professional Modifier None Typical Low $1,348.96 Median $2,041.74 Typical High $2,238.72 | Professional | None | $1,348.96 | $2,041.74 | $2,238.72 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $1,548.82 Typical High $1,819.70 | Professional | None | $30.20 | $1,548.82 | $1,819.70 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $1,698.24 Median $2,691.53 Typical High $128,824.96 | Facility | None | $1,698.24 | $2,691.53 | $128,824.96 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $151,356.12 | Professional | None | $2,137.96 | $2,691.53 | $151,356.12 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,995.26 Median $2,041.74 Typical High $3,090.30 | Facility | None | $1,995.26 | $2,041.74 | $3,090.30 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $2,238.72 | Professional | None | $1,479.11 | $1,479.11 | $2,238.72 |
Select Health Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,754.23 | Facility | None | $2,137.96 | $2,137.96 | $2,754.23 |
Select Health Setting Professional Modifier None Typical Low $1,380.38 Median $2,137.96 Typical High $2,344.23 | Professional | None | $1,380.38 | $2,137.96 | $2,344.23 |
United Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $1,380.38 | Facility | None | $776.25 | $776.25 | $1,380.38 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,047.13 Typical High $1,621.81 | Professional | None | $954.99 | $1,047.13 | $1,621.81 |
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 $676.08 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $676.08 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $269.15 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $204.17 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $134.90 | $173.78 | $173.78 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,548.82 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,548.82 | $1,621.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $676.08 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $676.08 | $870.96 | $870.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $269.15 | $354.81 | $354.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $204.17 | $263.03 | $263.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $134.90 | $173.78 | $173.78 |
Where Idaho sits
The same service costs 2.7 times more in Hawaii than in Pennsylvania. 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· 13th of 51
$1,820
HI $3,020PA $1,122
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.