How much rates vary
Facilitymedian $2,089 · 10th to 90th $1,175 to $3,467Professionalmedian $1,820 · 10th to 90th $851 to $2,754
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 $1,819.70 Typical High $1,819.70 | Professional | None | $1,380.38 | $1,819.70 | $1,819.70 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,548.82 Median $2,089.30 Typical High $3,467.37 | Facility | None | $1,548.82 | $2,089.30 | $3,467.37 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,548.82 Median $2,290.87 Typical High $2,398.83 | Professional | None | $1,548.82 | $2,290.87 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,230.27 | Facility | None | $1,174.90 | $1,174.90 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,174.90 | Professional | None | $851.14 | $851.14 | $1,174.90 |
Moda Health Setting Facility Modifier None Typical Low $602.56 Median $1,819.70 Typical High $2,187.76 | Facility | None | $602.56 | $1,819.70 | $2,187.76 |
Moda Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,949.84 Typical High $2,290.87 | Professional | None | $1,380.38 | $1,949.84 | $2,290.87 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $1,584.89 Typical High $1,862.09 | Professional | None | $30.20 | $1,584.89 | $1,862.09 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $1,737.80 Median $2,754.23 Typical High $131,825.67 | Facility | None | $1,737.80 | $2,754.23 | $131,825.67 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,187.76 Median $2,754.23 Typical High $154,881.66 | Professional | None | $2,187.76 | $2,754.23 | $154,881.66 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,041.74 Median $2,089.30 Typical High $3,162.28 | Facility | None | $2,041.74 | $2,089.30 | $3,162.28 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $2,290.87 | Professional | None | $1,548.82 | $1,548.82 | $2,290.87 |
Select Health Setting Facility Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,818.38 | Facility | None | $2,187.76 | $2,187.76 | $2,818.38 |
Select Health Setting Professional Modifier None Typical Low $1,412.54 Median $2,187.76 Typical High $2,398.83 | Professional | None | $1,412.54 | $2,187.76 | $2,398.83 |
United Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $933.25 | Facility | None | $741.31 | $741.31 | $933.25 |
United Setting Professional Modifier None Typical Low $870.96 Median $933.25 Typical High $1,445.44 | Professional | None | $870.96 | $933.25 | $1,445.44 |
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 $281.84 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $281.84 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $208.93 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $138.04 | $181.97 | $181.97 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,621.81 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,621.81 | $1,698.24 |
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 $281.84 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $281.84 | $363.08 | $363.08 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $208.93 | $269.15 | $269.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $138.04 | $181.97 | $181.97 |
Where Idaho sits
The same service costs 3.0 times more in Montana 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· 10th of 51
$1,862
MT $2,512DE $851
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.