How much rates vary
Facilitymedian $871 · 10th to 90th $562 to $1,479Professionalmedian $759 · 10th to 90th $427 to $1,148
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 $588.84 Median $758.58 Typical High $758.58 | Professional | None | $588.84 | $758.58 | $758.58 |
BCBS Idaho Setting Facility Modifier None Typical Low $707.95 Median $870.96 Typical High $1,479.11 | Facility | None | $707.95 | $870.96 | $1,479.11 |
BCBS Idaho Setting Professional Modifier None Typical Low $645.65 Median $954.99 Typical High $1,000.00 | Professional | None | $645.65 | $954.99 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $645.65 | Facility | None | $588.84 | $588.84 | $645.65 |
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 $275.42 Median $758.58 Typical High $912.01 | Facility | None | $275.42 | $758.58 | $912.01 |
Moda Health Setting Professional Modifier None Typical Low $588.84 Median $831.76 Typical High $954.99 | Professional | None | $588.84 | $831.76 | $954.99 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $660.69 Typical High $776.25 | Professional | None | $30.20 | $660.69 | $776.25 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $691.83 Median $1,148.15 Typical High $54,954.09 | Facility | None | $691.83 | $1,148.15 | $54,954.09 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $912.01 Median $1,148.15 Typical High $64,565.42 | Professional | None | $912.01 | $1,148.15 | $64,565.42 |
Regence BlueShield Setting Facility Modifier None Typical Low $851.14 Median $870.96 Typical High $1,318.26 | Facility | None | $851.14 | $870.96 | $1,318.26 |
Regence BlueShield Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $954.99 | Professional | None | $645.65 | $645.65 | $954.99 |
Select Health Setting Facility Modifier None Typical Low $870.96 Median $912.01 Typical High $1,174.90 | Facility | None | $870.96 | $912.01 | $1,174.90 |
Select Health Setting Professional Modifier None Typical Low $588.84 Median $912.01 Typical High $1,000.00 | Professional | None | $588.84 | $912.01 | $1,000.00 |
United Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $524.81 | Facility | None | $501.19 | $501.19 | $524.81 |
United Setting Professional Modifier None Typical Low $398.11 Median $426.58 Typical High $660.69 | Professional | None | $398.11 | $426.58 | $660.69 |
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 $288.40 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $288.40 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $117.49 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $87.10 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $58.88 | $75.86 | $75.86 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $676.08 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $602.56 | $676.08 | $707.95 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $288.40 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $288.40 | $380.19 | $380.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $117.49 | $151.36 | $151.36 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $87.10 | $112.20 | $112.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $58.88 | $75.86 | $75.86 |
Where Idaho sits
The same service costs 2.8 times more in Hawaii than in West Virginia. 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· 14th of 51
$776
HI $1,175WV $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.