How much rates vary
Facilitymedian $4,677 · 10th to 90th $3,020 to $7,762Professionalmedian $4,074 · 10th to 90th $2,042 to $6,166
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 $3,162.28 Median $4,073.80 Typical High $4,073.80 | Professional | None | $3,162.28 | $4,073.80 | $4,073.80 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,548.13 Median $4,677.35 Typical High $7,762.47 | Facility | None | $3,548.13 | $4,677.35 | $7,762.47 |
BCBS Idaho Setting Professional Modifier None Typical Low $3,467.37 Median $5,248.07 Typical High $5,495.41 | Professional | None | $3,467.37 | $5,248.07 | $5,495.41 |
Cigna Setting Facility Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,548.13 | Facility | None | $3,388.44 | $3,388.44 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $3,388.44 | Professional | None | $2,454.71 | $2,454.71 | $3,388.44 |
Moda Health Setting Facility Modifier None Typical Low $1,318.26 Median $4,073.80 Typical High $4,897.79 | Facility | None | $1,318.26 | $4,073.80 | $4,897.79 |
Moda Health Setting Professional Modifier None Typical Low $3,162.28 Median $4,466.84 Typical High $5,248.07 | Professional | None | $3,162.28 | $4,466.84 | $5,248.07 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $3,548.13 Typical High $4,168.69 | Professional | None | $30.20 | $3,548.13 | $4,168.69 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $3,801.89 Median $6,165.95 Typical High $295,120.92 | Facility | None | $3,801.89 | $6,165.95 | $295,120.92 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $4,897.79 Median $6,165.95 Typical High $346,736.85 | Professional | None | $4,897.79 | $6,165.95 | $346,736.85 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,570.88 Median $4,677.35 Typical High $7,079.46 | Facility | None | $4,570.88 | $4,677.35 | $7,079.46 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $5,248.07 | Professional | None | $3,467.37 | $3,467.37 | $5,248.07 |
Select Health Setting Facility Modifier None Typical Low $4,786.30 Median $4,897.79 Typical High $6,309.57 | Facility | None | $4,786.30 | $4,897.79 | $6,309.57 |
Select Health Setting Professional Modifier None Typical Low $3,235.94 Median $4,897.79 Typical High $5,370.32 | Professional | None | $3,235.94 | $4,897.79 | $5,370.32 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Facility | None | $2,398.83 | $2,398.83 | $2,398.83 |
United Setting Professional Modifier None Typical Low $1,862.09 Median $2,041.74 Typical High $3,162.28 | Professional | None | $1,862.09 | $2,041.74 | $3,162.28 |
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 $1,584.89 Median $2,041.74 Typical High $2,041.74 | Professional | 52 · Reduced service | $1,584.89 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $630.96 Median $812.83 Typical High $812.83 | Professional | 53 · Discontinued | $630.96 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $467.74 Median $616.60 Typical High $616.60 | Professional | 55 · Aftercare only | $467.74 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $316.23 Median $407.38 Typical High $407.38 | Professional | 56 · Pre-op care only | $316.23 | $407.38 | $407.38 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,235.94 Median $3,630.78 Typical High $3,801.89 | Professional | 78 · Unplanned return to OR | $3,235.94 | $3,630.78 | $3,801.89 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,584.89 Median $2,041.74 Typical High $2,041.74 | Professional | 52 · Reduced service | $1,584.89 | $2,041.74 | $2,041.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $630.96 Median $812.83 Typical High $812.83 | Professional | 53 · Discontinued | $630.96 | $812.83 | $812.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $467.74 Median $616.60 Typical High $616.60 | Professional | 55 · Aftercare only | $467.74 | $616.60 | $616.60 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $316.23 Median $407.38 Typical High $407.38 | Professional | 56 · Pre-op care only | $316.23 | $407.38 | $407.38 |
Where Idaho sits
The same service costs 2.1 times more in Montana than in South Carolina. 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
$4,169
MT $4,898SC $2,344
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.