How much rates vary
Facilitymedian $3,020 · 10th to 90th $1,950 to $5,012Professionalmedian $2,630 · 10th to 90th $1,413 to $3,981
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 $1,995.26 Median $2,630.27 Typical High $2,630.27 | Professional | None | $1,995.26 | $2,630.27 | $2,630.27 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,238.72 Median $3,019.95 Typical High $5,011.87 | Facility | None | $2,238.72 | $3,019.95 | $5,011.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,238.72 Median $3,311.31 Typical High $3,467.37 | Professional | None | $2,238.72 | $3,311.31 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,187.76 | Facility | None | $2,041.74 | $2,041.74 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $2,041.74 | Professional | None | $1,513.56 | $1,513.56 | $2,041.74 |
Moda Health Setting Facility Modifier None Typical Low $912.01 Median $2,630.27 Typical High $3,162.28 | Facility | None | $912.01 | $2,630.27 | $3,162.28 |
Moda Health Setting Professional Modifier None Typical Low $1,995.26 Median $3,019.95 Typical High $3,311.31 | Professional | None | $1,995.26 | $3,019.95 | $3,311.31 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $2,290.87 Typical High $2,691.53 | Professional | None | $30.20 | $2,290.87 | $2,691.53 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $2,511.89 Median $3,981.07 Typical High $190,546.07 | Facility | None | $2,511.89 | $3,981.07 | $190,546.07 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $3,162.28 Median $3,981.07 Typical High $223,872.11 | Professional | None | $3,162.28 | $3,981.07 | $223,872.11 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,951.21 Median $3,019.95 Typical High $4,570.88 | Facility | None | $2,951.21 | $3,019.95 | $4,570.88 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $3,311.31 | Professional | None | $2,238.72 | $2,238.72 | $3,311.31 |
Select Health Setting Facility Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $4,073.80 | Facility | None | $3,162.28 | $3,162.28 | $4,073.80 |
Select Health Setting Professional Modifier None Typical Low $2,041.74 Median $3,162.28 Typical High $3,467.37 | Professional | None | $2,041.74 | $3,162.28 | $3,467.37 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,949.84 | Facility | None | $1,905.46 | $1,905.46 | $1,949.84 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $1,412.54 Typical High $2,187.76 | Professional | None | $1,318.26 | $1,412.54 | $2,187.76 |
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 $1,000.00 Median $1,318.26 Typical High $1,318.26 | Professional | 52 · Reduced service | $1,000.00 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $524.81 Typical High $524.81 | Professional | 53 · Discontinued | $407.38 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $389.05 Typical High $389.05 | Professional | 55 · Aftercare only | $302.00 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $263.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $199.53 | $263.03 | $263.03 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,089.30 Median $2,344.23 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $2,089.30 | $2,344.23 | $2,454.71 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,000.00 Median $1,318.26 Typical High $1,318.26 | Professional | 52 · Reduced service | $1,000.00 | $1,318.26 | $1,318.26 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $524.81 Typical High $524.81 | Professional | 53 · Discontinued | $407.38 | $524.81 | $524.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $389.05 Typical High $389.05 | Professional | 55 · Aftercare only | $302.00 | $389.05 | $389.05 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $263.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $199.53 | $263.03 | $263.03 |
Where Idaho sits
The same service costs 3.1 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· 12th of 51
$2,692
HI $4,677PA $1,514
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.