How much rates vary
Facilitymedian $4,571 · 10th to 90th $2,884 to $7,586Professionalmedian $3,981 · 10th to 90th $2,089 to $6,026
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 $3,090.30 Median $3,981.07 Typical High $3,981.07 | Professional | None | $3,090.30 | $3,981.07 | $3,981.07 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,467.37 Median $4,570.88 Typical High $7,585.78 | Facility | None | $3,467.37 | $4,570.88 | $7,585.78 |
BCBS Idaho Setting Professional Modifier None Typical Low $3,388.44 Median $5,011.87 Typical High $5,248.07 | Professional | None | $3,388.44 | $5,011.87 | $5,248.07 |
Cigna Setting Facility Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $3,019.95 | Facility | None | $2,884.03 | $2,884.03 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,884.03 | Professional | None | $2,089.30 | $2,089.30 | $2,884.03 |
Moda Health Setting Facility Modifier None Typical Low $1,380.38 Median $3,981.07 Typical High $4,786.30 | Facility | None | $1,380.38 | $3,981.07 | $4,786.30 |
Moda Health Setting Professional Modifier None Typical Low $3,090.30 Median $4,365.16 Typical High $5,011.87 | Professional | None | $3,090.30 | $4,365.16 | $5,011.87 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $3,467.37 Typical High $4,073.80 | Professional | None | $30.20 | $3,467.37 | $4,073.80 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $3,890.45 Median $6,025.60 Typical High $288,403.15 | Facility | None | $3,890.45 | $6,025.60 | $288,403.15 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $4,786.30 Median $6,025.60 Typical High $338,844.16 | Professional | None | $4,786.30 | $6,025.60 | $338,844.16 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,466.84 Median $4,570.88 Typical High $6,918.31 | Facility | None | $4,466.84 | $4,570.88 | $6,918.31 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $5,011.87 | Professional | None | $3,388.44 | $3,388.44 | $5,011.87 |
Select Health Setting Facility Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $6,165.95 | Facility | None | $4,786.30 | $4,786.30 | $6,165.95 |
Select Health Setting Professional Modifier None Typical Low $3,090.30 Median $4,786.30 Typical High $5,248.07 | Professional | None | $3,090.30 | $4,786.30 | $5,248.07 |
United Setting Professional Modifier None Typical Low $1,995.26 Median $2,137.96 Typical High $3,311.31 | Professional | None | $1,995.26 | $2,137.96 | $3,311.31 |
5 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 55 · Aftercare only Typical Low $457.09 Median $588.84 Typical High $588.84 | Professional | 55 · Aftercare only | $457.09 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $309.03 Median $398.11 Typical High $398.11 | Professional | 56 · Pre-op care only | $309.03 | $398.11 | $398.11 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,162.28 Median $3,548.13 Typical High $3,715.35 | Professional | 78 · Unplanned return to OR | $3,162.28 | $3,548.13 | $3,715.35 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $457.09 Median $588.84 Typical High $588.84 | Professional | 55 · Aftercare only | $457.09 | $588.84 | $588.84 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $309.03 Median $398.11 Typical High $398.11 | Professional | 56 · Pre-op care only | $309.03 | $398.11 | $398.11 |
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· 13th of 51
$4,074
MT $5,012DE $2,089
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.