How much rates vary
Facilitymedian $3,388 · 10th to 90th $2,138 to $5,623Professionalmedian $2,884 · 10th to 90th $1,549 to $4,467
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 $2,238.72 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,238.72 | $2,884.03 | $2,884.03 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,511.89 Median $3,388.44 Typical High $5,623.41 | Facility | None | $2,511.89 | $3,388.44 | $5,623.41 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,454.71 Median $3,715.35 Typical High $3,890.45 | Professional | None | $2,454.71 | $3,715.35 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,691.53 | Facility | None | $2,570.40 | $2,570.40 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,570.40 | Professional | None | $1,862.09 | $1,862.09 | $2,570.40 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $2,884.03 Typical High $3,548.13 | Facility | None | $1,000.00 | $2,884.03 | $3,548.13 |
Moda Health Setting Professional Modifier None Typical Low $2,238.72 Median $3,162.28 Typical High $3,715.35 | Professional | None | $2,238.72 | $3,162.28 | $3,715.35 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $2,570.40 Typical High $3,019.95 | Professional | None | $30.20 | $2,570.40 | $3,019.95 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $2,818.38 Median $4,466.84 Typical High $213,796.21 | Facility | None | $2,818.38 | $4,466.84 | $213,796.21 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $3,548.13 Median $4,466.84 Typical High $251,188.64 | Professional | None | $3,548.13 | $4,466.84 | $251,188.64 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,311.31 Median $3,388.44 Typical High $5,128.61 | Facility | None | $3,311.31 | $3,388.44 | $5,128.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $3,715.35 | Professional | None | $2,454.71 | $2,454.71 | $3,715.35 |
Select Health Setting Facility Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $4,570.88 | Facility | None | $3,548.13 | $3,548.13 | $4,570.88 |
Select Health Setting Professional Modifier None Typical Low $2,290.87 Median $3,548.13 Typical High $3,890.45 | Professional | None | $2,290.87 | $3,548.13 | $3,890.45 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,659.59 | Facility | None | $1,288.25 | $1,288.25 | $1,659.59 |
United Setting Professional Modifier None Typical Low $1,412.54 Median $1,548.82 Typical High $2,344.23 | Professional | None | $1,412.54 | $1,548.82 | $2,344.23 |
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 $1,122.02 Median $1,445.44 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,122.02 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $588.84 Typical High $588.84 | Professional | 53 · Discontinued | $446.68 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $436.52 Typical High $436.52 | Professional | 55 · Aftercare only | $338.84 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $288.40 Typical High $288.40 | Professional | 56 · Pre-op care only | $223.87 | $288.40 | $288.40 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,290.87 Median $2,570.40 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $2,290.87 | $2,570.40 | $2,691.53 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,122.02 Median $1,445.44 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,122.02 | $1,445.44 | $1,445.44 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $588.84 Typical High $588.84 | Professional | 53 · Discontinued | $446.68 | $588.84 | $588.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $436.52 Typical High $436.52 | Professional | 55 · Aftercare only | $338.84 | $436.52 | $436.52 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $288.40 Typical High $288.40 | Professional | 56 · Pre-op care only | $223.87 | $288.40 | $288.40 |
Where Idaho sits
The same service costs 2.4 times more in Wisconsin 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
$3,020
WI $3,981DC $1,660
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.