How much rates vary
Facilitymedian $1,514 · 10th to 90th $955 to $2,512Professionalmedian $1,288 · 10th to 90th $692 to $1,995
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 $1,000.00 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,000.00 | $1,288.25 | $1,288.25 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,122.02 Median $1,513.56 Typical High $2,511.89 | Facility | None | $1,122.02 | $1,513.56 | $2,511.89 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,096.48 Median $1,659.59 Typical High $1,737.80 | Professional | None | $1,096.48 | $1,659.59 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $1,000.00 | Facility | None | $954.99 | $954.99 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $954.99 | Professional | None | $691.83 | $691.83 | $954.99 |
Moda Health Setting Facility Modifier None Typical Low $457.09 Median $1,288.25 Typical High $1,584.89 | Facility | None | $457.09 | $1,288.25 | $1,584.89 |
Moda Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,412.54 Typical High $1,659.59 | Professional | None | $1,000.00 | $1,412.54 | $1,659.59 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $1,148.15 Typical High $1,348.96 | Professional | None | $30.20 | $1,148.15 | $1,348.96 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $1,258.93 Median $1,995.26 Typical High $95,499.26 | Facility | None | $1,258.93 | $1,995.26 | $95,499.26 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,584.89 Median $1,995.26 Typical High $112,201.85 | Professional | None | $1,584.89 | $1,995.26 | $112,201.85 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,479.11 Median $1,513.56 Typical High $2,290.87 | Facility | None | $1,479.11 | $1,513.56 | $2,290.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,659.59 | Professional | None | $1,096.48 | $1,096.48 | $1,659.59 |
Select Health Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $2,041.74 | Facility | None | $1,584.89 | $1,584.89 | $2,041.74 |
Select Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,584.89 Typical High $1,737.80 | Professional | None | $1,023.29 | $1,584.89 | $1,737.80 |
United Setting Professional Modifier None Typical Low $660.69 Median $707.95 Typical High $1,096.48 | Professional | None | $660.69 | $707.95 | $1,096.48 |
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 $501.19 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $501.19 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $199.53 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $151.36 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $100.00 | $128.82 | $128.82 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,174.90 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,174.90 | $1,230.27 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $501.19 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $501.19 | $645.65 | $645.65 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $199.53 | $263.03 | $263.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $151.36 | $194.98 | $194.98 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $100.00 | $128.82 | $128.82 |
Where Idaho sits
The same service costs 2.4 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· 12th of 51
$1,349
MT $1,660DE $692
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.