How much rates vary
Facilitymedian $2,951 · 10th to 90th $1,950 to $4,898Professionalmedian $2,570 · 10th to 90th $1,445 to $3,890
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 $1,949.84 Median $2,570.40 Typical High $2,570.40 | Professional | None | $1,949.84 | $2,570.40 | $2,570.40 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,398.83 Median $2,951.21 Typical High $4,897.79 | Facility | None | $2,398.83 | $2,951.21 | $4,897.79 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,187.76 Median $3,235.94 Typical High $3,388.44 | Professional | None | $2,187.76 | $3,235.94 | $3,388.44 |
Cigna Setting Facility Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,398.83 | Facility | None | $2,290.87 | $2,290.87 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $2,290.87 | Professional | None | $1,659.59 | $1,659.59 | $2,290.87 |
Moda Health Setting Facility Modifier None Typical Low $933.25 Median $2,570.40 Typical High $3,090.30 | Facility | None | $933.25 | $2,570.40 | $3,090.30 |
Moda Health Setting Professional Modifier None Typical Low $1,949.84 Median $2,951.21 Typical High $3,235.94 | Professional | None | $1,949.84 | $2,951.21 | $3,235.94 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $2,238.72 Typical High $2,630.27 | Professional | None | $30.20 | $2,238.72 | $2,630.27 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $2,454.71 Median $3,890.45 Typical High $186,208.71 | Facility | None | $2,454.71 | $3,890.45 | $186,208.71 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $3,090.30 Median $3,890.45 Typical High $218,776.16 | Professional | None | $3,090.30 | $3,890.45 | $218,776.16 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,884.03 Median $2,951.21 Typical High $4,466.84 | Facility | None | $2,884.03 | $2,951.21 | $4,466.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $3,235.94 | Professional | None | $2,187.76 | $2,187.76 | $3,235.94 |
Select Health Setting Facility Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,981.07 | Facility | None | $3,090.30 | $3,090.30 | $3,981.07 |
Select Health Setting Professional Modifier None Typical Low $1,995.26 Median $3,090.30 Typical High $3,388.44 | Professional | None | $1,995.26 | $3,090.30 | $3,388.44 |
United Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,905.46 | Facility | None | $1,778.28 | $1,778.28 | $1,905.46 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $2,238.72 | Professional | None | $1,318.26 | $1,445.44 | $2,238.72 |
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 $977.24 Median $1,288.25 Typical High $1,288.25 | Professional | 52 · Reduced service | $977.24 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $512.86 Typical High $512.86 | Professional | 53 · Discontinued | $398.11 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $380.19 Typical High $380.19 | Professional | 55 · Aftercare only | $295.12 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $257.04 Typical High $257.04 | Professional | 56 · Pre-op care only | $194.98 | $257.04 | $257.04 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,041.74 Median $2,290.87 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $2,041.74 | $2,290.87 | $2,398.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $977.24 Median $1,288.25 Typical High $1,288.25 | Professional | 52 · Reduced service | $977.24 | $1,288.25 | $1,288.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $512.86 Typical High $512.86 | Professional | 53 · Discontinued | $398.11 | $512.86 | $512.86 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $380.19 Typical High $380.19 | Professional | 55 · Aftercare only | $295.12 | $380.19 | $380.19 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $257.04 Typical High $257.04 | Professional | 56 · Pre-op care only | $194.98 | $257.04 | $257.04 |
Where Idaho sits
The same service costs 2.8 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· 14th of 51
$2,630
HI $4,365PA $1,549
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.