How much rates vary
Facilitymedian $5,248 · 10th to 90th $3,236 to $8,710Professionalmedian $4,571 · 10th to 90th $2,399 to $6,918
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 $3,548.13 Median $4,570.88 Typical High $4,570.88 | Professional | None | $3,548.13 | $4,570.88 | $4,570.88 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,981.07 Median $5,248.07 Typical High $8,709.64 | Facility | None | $3,981.07 | $5,248.07 | $8,709.64 |
BCBS Idaho Setting Professional Modifier None Typical Low $3,890.45 Median $5,754.40 Typical High $6,025.60 | Professional | None | $3,890.45 | $5,754.40 | $6,025.60 |
Cigna Setting Facility Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,801.89 | Facility | None | $3,548.13 | $3,548.13 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $3,548.13 | Professional | None | $2,630.27 | $2,630.27 | $3,548.13 |
Moda Health Setting Facility Modifier None Typical Low $1,548.82 Median $4,570.88 Typical High $5,495.41 | Facility | None | $1,548.82 | $4,570.88 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $3,548.13 Median $5,011.87 Typical High $5,754.40 | Professional | None | $3,548.13 | $5,011.87 | $5,754.40 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $3,981.07 Typical High $4,677.35 | Professional | None | $30.20 | $3,981.07 | $4,677.35 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $3,890.45 Median $6,918.31 Typical High $331,131.12 | Facility | None | $3,890.45 | $6,918.31 | $331,131.12 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $5,495.41 Median $6,918.31 Typical High $389,045.14 | Professional | None | $5,495.41 | $6,918.31 | $389,045.14 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,128.61 Median $5,248.07 Typical High $7,943.28 | Facility | None | $5,128.61 | $5,248.07 | $7,943.28 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $5,754.40 | Professional | None | $3,890.45 | $3,890.45 | $5,754.40 |
Select Health Setting Facility Modifier None Typical Low $5,128.61 Median $5,495.41 Typical High $7,079.46 | Facility | None | $5,128.61 | $5,495.41 | $7,079.46 |
Select Health Setting Professional Modifier None Typical Low $3,630.78 Median $5,495.41 Typical High $6,025.60 | Professional | None | $3,630.78 | $5,495.41 | $6,025.60 |
United Setting Facility Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $4,365.16 | Facility | None | $3,235.94 | $3,235.94 | $4,365.16 |
United Setting Professional Modifier None Typical Low $2,238.72 Median $2,398.83 Typical High $3,715.35 | Professional | None | $2,238.72 | $2,398.83 | $3,715.35 |
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 $1,778.28 Median $2,290.87 Typical High $2,290.87 | Professional | 52 · Reduced service | $1,778.28 | $2,290.87 | $2,290.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $707.95 Median $912.01 Typical High $912.01 | Professional | 53 · Discontinued | $707.95 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $524.81 Median $676.08 Typical High $676.08 | Professional | 55 · Aftercare only | $524.81 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $354.81 Median $457.09 Typical High $457.09 | Professional | 56 · Pre-op care only | $354.81 | $457.09 | $457.09 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,630.78 Median $4,073.80 Typical High $4,265.80 | Professional | 78 · Unplanned return to OR | $3,630.78 | $4,073.80 | $4,265.80 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,778.28 Median $2,290.87 Typical High $2,290.87 | Professional | 52 · Reduced service | $1,778.28 | $2,290.87 | $2,290.87 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $707.95 Median $912.01 Typical High $912.01 | Professional | 53 · Discontinued | $707.95 | $912.01 | $912.01 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $524.81 Median $676.08 Typical High $676.08 | Professional | 55 · Aftercare only | $524.81 | $676.08 | $676.08 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $354.81 Median $457.09 Typical High $457.09 | Professional | 56 · Pre-op care only | $354.81 | $457.09 | $457.09 |
Where Idaho sits
The same service costs 4.3 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· 9th of 51
$4,677
HI $11,220PA $2,630
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.