How much rates vary
Facilitymedian $1,950 · 10th to 90th $1,288 to $3,311Professionalmedian $1,660 · 10th to 90th $912 to $2,512
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 $1,288.25 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,288.25 | $1,659.59 | $1,659.59 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,584.89 Median $1,949.84 Typical High $3,311.31 | Facility | None | $1,584.89 | $1,949.84 | $3,311.31 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,412.54 Median $2,137.96 Typical High $2,238.72 | Professional | None | $1,412.54 | $2,137.96 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,380.38 | Facility | None | $1,318.26 | $1,318.26 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,318.26 | Professional | None | $954.99 | $954.99 | $1,318.26 |
Moda Health Setting Facility Modifier None Typical Low $588.84 Median $1,659.59 Typical High $2,041.74 | Facility | None | $588.84 | $1,659.59 | $2,041.74 |
Moda Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,819.70 Typical High $2,137.96 | Professional | None | $1,288.25 | $1,819.70 | $2,137.96 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $1,445.44 Typical High $1,698.24 | Professional | None | $30.20 | $1,445.44 | $1,698.24 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $1,621.81 Median $2,511.89 Typical High $123,026.88 | Facility | None | $1,621.81 | $2,511.89 | $123,026.88 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,137.96 Median $2,511.89 Typical High $141,253.75 | Professional | None | $2,137.96 | $2,511.89 | $141,253.75 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,905.46 Median $1,949.84 Typical High $2,884.03 | Facility | None | $1,905.46 | $1,949.84 | $2,884.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $2,137.96 | Professional | None | $1,412.54 | $1,412.54 | $2,137.96 |
Select Health Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,630.27 | Facility | None | $2,041.74 | $2,041.74 | $2,630.27 |
Select Health Setting Professional Modifier None Typical Low $1,318.26 Median $2,041.74 Typical High $2,238.72 | Professional | None | $1,318.26 | $2,041.74 | $2,238.72 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Facility | None | $1,000.00 | $1,000.00 | $1,000.00 |
United Setting Professional Modifier None Typical Low $831.76 Median $912.01 Typical High $1,412.54 | Professional | None | $831.76 | $912.01 | $1,412.54 |
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 $645.65 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $645.65 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $257.04 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $194.98 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $128.82 | $165.96 | $165.96 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,479.11 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,479.11 | $1,548.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $645.65 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $645.65 | $831.76 | $831.76 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $257.04 | $331.13 | $331.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $194.98 | $251.19 | $251.19 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $128.82 | $165.96 | $165.96 |
Where Idaho sits
The same service costs 3.0 times more in Kansas 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· 16th of 51
$1,698
KS $2,818DE $955
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.