How much rates vary
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 $1,380.38 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,380.38 | $1,778.28 | $1,778.28 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,698.24 Median $2,089.30 Typical High $3,388.44 | Facility | None | $1,698.24 | $2,089.30 | $3,388.44 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,513.56 Median $2,290.87 Typical High $2,398.83 | Professional | None | $1,513.56 | $2,290.87 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,348.96 | Facility | None | $1,230.27 | $1,230.27 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,230.27 | Professional | None | $891.25 | $891.25 | $1,230.27 |
Moda Health Setting Facility Modifier None Typical Low $616.60 Median $1,778.28 Typical High $2,137.96 | Facility | None | $616.60 | $1,778.28 | $2,137.96 |
Moda Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,995.26 Typical High $2,290.87 | Professional | None | $1,380.38 | $1,995.26 | $2,290.87 |
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 $1,737.80 Median $2,691.53 Typical High $128,824.96 | Facility | None | $1,737.80 | $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 $2,089.30 Typical High $3,090.30 | Facility | None | $1,995.26 | $2,089.30 | $3,090.30 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $2,290.87 | Professional | None | $1,513.56 | $1,513.56 | $2,290.87 |
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 $1,412.54 Median $2,137.96 Typical High $2,344.23 | Professional | None | $1,412.54 | $2,137.96 | $2,344.23 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,202.26 | Facility | None | $1,071.52 | $1,071.52 | $1,202.26 |
United Setting Professional Modifier None Typical Low $891.25 Median $954.99 Typical High $1,479.11 | Professional | None | $891.25 | $954.99 | $1,479.11 |
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 $691.83 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $691.83 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $275.42 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $204.17 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $138.04 | $177.83 | $177.83 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,584.89 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,584.89 | $1,659.59 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $691.83 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $691.83 | $891.25 | $891.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $275.42 | $354.81 | $354.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $204.17 | $269.15 | $269.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $138.04 | $177.83 | $177.83 |
Where Idaho sits
The same service costs 3.1 times more in Hawaii than in Delaware. 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
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.