How much rates vary
Facilitymedian $6,166 · 10th to 90th $3,715 to $10,233Professionalmedian $5,370 · 10th to 90th $2,630 to $8,128
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 $4,168.69 Median $5,370.32 Typical High $5,370.32 | Professional | None | $4,168.69 | $5,370.32 | $5,370.32 |
BCBS Idaho Setting Facility Modifier None Typical Low $4,677.35 Median $6,165.95 Typical High $10,232.93 | Facility | None | $4,677.35 | $6,165.95 | $10,232.93 |
BCBS Idaho Setting Professional Modifier None Typical Low $4,570.88 Median $6,760.83 Typical High $7,079.46 | Professional | None | $4,570.88 | $6,760.83 | $7,079.46 |
Cigna Setting Facility Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $4,168.69 | Facility | None | $3,715.35 | $3,715.35 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $3,715.35 | Professional | None | $2,754.23 | $2,754.23 | $3,715.35 |
Moda Health Setting Facility Modifier None Typical Low $1,698.24 Median $5,370.32 Typical High $6,456.54 | Facility | None | $1,698.24 | $5,370.32 | $6,456.54 |
Moda Health Setting Professional Modifier None Typical Low $4,168.69 Median $5,888.44 Typical High $6,760.83 | Professional | None | $4,168.69 | $5,888.44 | $6,760.83 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $4,677.35 Typical High $5,495.41 | Professional | None | $30.20 | $4,677.35 | $5,495.41 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $5,011.87 Median $8,128.31 Typical High $389,045.14 | Facility | None | $5,011.87 | $8,128.31 | $389,045.14 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $6,456.54 Median $8,128.31 Typical High $457,088.19 | Professional | None | $6,456.54 | $8,128.31 | $457,088.19 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,025.60 Median $6,165.95 Typical High $9,332.54 | Facility | None | $6,025.60 | $6,165.95 | $9,332.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $6,760.83 | Professional | None | $4,570.88 | $4,570.88 | $6,760.83 |
Select Health Setting Facility Modifier None Typical Low $6,456.54 Median $6,456.54 Typical High $8,317.64 | Facility | None | $6,456.54 | $6,456.54 | $8,317.64 |
Select Health Setting Professional Modifier None Typical Low $4,265.80 Median $6,456.54 Typical High $7,079.46 | Professional | None | $4,265.80 | $6,456.54 | $7,079.46 |
United Setting Facility Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Facility | None | $3,467.37 | $3,467.37 | $3,467.37 |
United Setting Professional Modifier None Typical Low $2,398.83 Median $2,630.27 Typical High $3,981.07 | Professional | None | $2,398.83 | $2,630.27 | $3,981.07 |
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 $2,089.30 Median $2,691.53 Typical High $2,691.53 | Professional | 52 · Reduced service | $2,089.30 | $2,691.53 | $2,691.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $831.76 Median $1,071.52 Typical High $1,071.52 | Professional | 53 · Discontinued | $831.76 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $616.60 Median $812.83 Typical High $812.83 | Professional | 55 · Aftercare only | $616.60 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $416.87 Median $537.03 Typical High $537.03 | Professional | 56 · Pre-op care only | $416.87 | $537.03 | $537.03 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $4,265.80 Median $4,786.30 Typical High $5,011.87 | Professional | 78 · Unplanned return to OR | $4,265.80 | $4,786.30 | $5,011.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2,089.30 Median $2,691.53 Typical High $2,691.53 | Professional | 52 · Reduced service | $2,089.30 | $2,691.53 | $2,691.53 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $831.76 Median $1,071.52 Typical High $1,071.52 | Professional | 53 · Discontinued | $831.76 | $1,071.52 | $1,071.52 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $616.60 Median $812.83 Typical High $812.83 | Professional | 55 · Aftercare only | $616.60 | $812.83 | $812.83 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $416.87 Median $537.03 Typical High $537.03 | Professional | 56 · Pre-op care only | $416.87 | $537.03 | $537.03 |
Where Idaho sits
The same service costs 2.9 times more in Hawaii than in Pennsylvania. 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
$5,495
HI $7,943PA $2,754
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.