How much rates vary
Facilitymedian $1,479 · 10th to 90th $871 to $2,455Professionalmedian $1,288 · 10th to 90th $631 to $1,950
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 $977.24 Median $1,288.25 Typical High $1,288.25 | Professional | None | $977.24 | $1,288.25 | $1,288.25 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,096.48 Median $1,479.11 Typical High $2,454.71 | Facility | None | $1,096.48 | $1,479.11 | $2,454.71 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,071.52 Median $1,621.81 Typical High $1,698.24 | Professional | None | $1,071.52 | $1,621.81 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $933.25 | Facility | None | $870.96 | $870.96 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $870.96 | Professional | None | $630.96 | $630.96 | $870.96 |
Moda Health Setting Facility Modifier None Typical Low $436.52 Median $1,288.25 Typical High $1,548.82 | Facility | None | $436.52 | $1,288.25 | $1,548.82 |
Moda Health Setting Professional Modifier None Typical Low $977.24 Median $1,479.11 Typical High $1,621.81 | Professional | None | $977.24 | $1,479.11 | $1,621.81 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $1,122.02 Typical High $1,318.26 | Professional | None | $30.20 | $1,122.02 | $1,318.26 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $1,230.27 Median $1,949.84 Typical High $93,325.43 | Facility | None | $1,230.27 | $1,949.84 | $93,325.43 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,548.82 Median $1,949.84 Typical High $109,647.82 | Professional | None | $1,548.82 | $1,949.84 | $109,647.82 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,445.44 Median $1,479.11 Typical High $2,238.72 | Facility | None | $1,445.44 | $1,479.11 | $2,238.72 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,621.81 | Professional | None | $1,071.52 | $1,071.52 | $1,621.81 |
Select Health Setting Facility Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,995.26 | Facility | None | $1,548.82 | $1,548.82 | $1,995.26 |
Select Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,548.82 Typical High $1,698.24 | Professional | None | $1,000.00 | $1,548.82 | $1,698.24 |
United Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $1,513.56 | Facility | None | $891.25 | $891.25 | $1,513.56 |
United Setting Professional Modifier None Typical Low $616.60 Median $676.08 Typical High $1,023.29 | Professional | None | $616.60 | $676.08 | $1,023.29 |
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 $489.78 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $489.78 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $194.98 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $147.91 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $97.72 | $128.82 | $128.82 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,148.15 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,148.15 | $1,202.26 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $489.78 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $489.78 | $630.96 | $630.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $194.98 | $257.04 | $257.04 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $147.91 | $190.55 | $190.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $97.72 | $128.82 | $128.82 |
Where Idaho sits
The same service costs 4.0 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· 11th of 51
$1,318
HI $2,512DE $631
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.