How much rates vary
Facilitymedian $3,802 · 10th to 90th $2,138 to $6,310Professionalmedian $3,311 · 10th to 90th $1,585 to $5,012
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 $2,570.40 Median $3,311.31 Typical High $3,311.31 | Professional | None | $2,570.40 | $3,311.31 | $3,311.31 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,884.03 Median $3,801.89 Typical High $6,309.57 | Facility | None | $2,884.03 | $3,801.89 | $6,309.57 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,818.38 Median $4,168.69 Typical High $4,365.16 | Professional | None | $2,818.38 | $4,168.69 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,454.71 | Facility | None | $2,137.96 | $2,137.96 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $2,137.96 | Professional | None | $1,584.89 | $1,584.89 | $2,137.96 |
Moda Health Setting Facility Modifier None Typical Low $1,122.02 Median $3,311.31 Typical High $3,981.07 | Facility | None | $1,122.02 | $3,311.31 | $3,981.07 |
Moda Health Setting Professional Modifier None Typical Low $2,570.40 Median $3,311.31 Typical High $4,168.69 | Professional | None | $2,570.40 | $3,311.31 | $4,168.69 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $2,884.03 Typical High $3,388.44 | Professional | None | $30.20 | $2,884.03 | $3,388.44 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $3,090.30 Median $5,011.87 Typical High $239,883.29 | Facility | None | $3,090.30 | $5,011.87 | $239,883.29 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $3,981.07 Median $5,011.87 Typical High $281,838.29 | Professional | None | $3,981.07 | $5,011.87 | $281,838.29 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,715.35 Median $3,801.89 Typical High $5,754.40 | Facility | None | $3,715.35 | $3,801.89 | $5,754.40 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $4,168.69 | Professional | None | $2,818.38 | $2,818.38 | $4,168.69 |
Select Health Setting Facility Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $5,128.61 | Facility | None | $3,981.07 | $3,981.07 | $5,128.61 |
Select Health Setting Professional Modifier None Typical Low $2,630.27 Median $3,981.07 Typical High $4,365.16 | Professional | None | $2,630.27 | $3,981.07 | $4,365.16 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Facility | None | $1,949.84 | $1,949.84 | $1,949.84 |
United Setting Professional Modifier None Typical Low $1,584.89 Median $1,737.80 Typical High $2,630.27 | Professional | None | $1,584.89 | $1,737.80 | $2,630.27 |
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 $1,288.25 Median $1,659.59 Typical High $1,659.59 | Professional | 52 · Reduced service | $1,288.25 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $660.69 Typical High $660.69 | Professional | 53 · Discontinued | $512.86 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $501.19 Typical High $501.19 | Professional | 55 · Aftercare only | $380.19 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $331.13 Typical High $331.13 | Professional | 56 · Pre-op care only | $257.04 | $331.13 | $331.13 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,630.27 Median $2,951.21 Typical High $3,090.30 | Professional | 78 · Unplanned return to OR | $2,630.27 | $2,951.21 | $3,090.30 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,288.25 Median $1,659.59 Typical High $1,659.59 | Professional | 52 · Reduced service | $1,288.25 | $1,659.59 | $1,659.59 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $660.69 Typical High $660.69 | Professional | 53 · Discontinued | $512.86 | $660.69 | $660.69 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $501.19 Typical High $501.19 | Professional | 55 · Aftercare only | $380.19 | $501.19 | $501.19 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $331.13 Typical High $331.13 | Professional | 56 · Pre-op care only | $257.04 | $331.13 | $331.13 |
Where Idaho sits
The same service costs 2.6 times more in Wisconsin 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· 11th of 51
$3,311
WI $4,074DE $1,585
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.