How much rates vary
Facilitymedian $776 · 10th to 90th $501 to $1,318Professionalmedian $661 · 10th to 90th $398 to $1,000
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 $512.86 Median $660.69 Typical High $660.69 | Professional | None | $512.86 | $660.69 | $660.69 |
BCBS Idaho Setting Facility Modifier None Typical Low $630.96 Median $776.25 Typical High $1,318.26 | Facility | None | $630.96 | $776.25 | $1,318.26 |
BCBS Idaho Setting Professional Modifier None Typical Low $562.34 Median $851.14 Typical High $891.25 | Professional | None | $562.34 | $851.14 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $616.60 | Facility | None | $588.84 | $588.84 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $588.84 | Professional | None | $426.58 | $426.58 | $588.84 |
Moda Health Setting Facility Modifier None Typical Low $257.04 Median $660.69 Typical High $812.83 | Facility | None | $257.04 | $660.69 | $812.83 |
Moda Health Setting Professional Modifier None Typical Low $512.86 Median $724.44 Typical High $851.14 | Professional | None | $512.86 | $724.44 | $851.14 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $575.44 Typical High $676.08 | Professional | None | $30.20 | $575.44 | $676.08 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $691.83 Median $1,000.00 Typical High $47,863.01 | Facility | None | $691.83 | $1,000.00 | $47,863.01 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $812.83 Median $1,000.00 Typical High $56,234.13 | Professional | None | $812.83 | $1,000.00 | $56,234.13 |
Regence BlueShield Setting Facility Modifier None Typical Low $758.58 Median $776.25 Typical High $1,148.15 | Facility | None | $758.58 | $776.25 | $1,148.15 |
Regence BlueShield Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $851.14 | Professional | None | $562.34 | $562.34 | $851.14 |
Select Health Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $1,071.52 | Facility | None | $812.83 | $812.83 | $1,071.52 |
Select Health Setting Professional Modifier None Typical Low $524.81 Median $812.83 Typical High $891.25 | Professional | None | $524.81 | $812.83 | $891.25 |
United Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $398.11 | Facility | None | $181.97 | $181.97 | $398.11 |
United Setting Professional Modifier None Typical Low $363.08 Median $398.11 Typical High $602.56 | Professional | None | $363.08 | $398.11 | $602.56 |
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 $257.04 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $257.04 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $102.33 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $77.62 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $51.29 | $66.07 | $66.07 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $588.84 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $524.81 | $588.84 | $616.60 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $257.04 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $257.04 | $331.13 | $331.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $102.33 | $131.83 | $131.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $77.62 | $100.00 | $100.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $51.29 | $66.07 | $66.07 |
Where Idaho sits
The same service costs 2.5 times more in Montana than in Alabama. 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
$676
MT $1,072AL $427
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.