How much rates vary
Facilitymedian $2,291 · 10th to 90th $1,349 to $3,802Professionalmedian $1,995 · 10th to 90th $977 to $3,020
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 $1,513.56 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,513.56 | $1,995.26 | $1,995.26 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,698.24 Median $2,290.87 Typical High $3,801.89 | Facility | None | $1,698.24 | $2,290.87 | $3,801.89 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $2,630.27 | Professional | None | $1,698.24 | $2,511.89 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,479.11 | Facility | None | $1,348.96 | $1,348.96 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,348.96 | Professional | None | $977.24 | $977.24 | $1,348.96 |
Moda Health Setting Facility Modifier None Typical Low $691.83 Median $1,995.26 Typical High $2,398.83 | Facility | None | $691.83 | $1,995.26 | $2,398.83 |
Moda Health Setting Professional Modifier None Typical Low $1,513.56 Median $2,137.96 Typical High $2,511.89 | Professional | None | $1,513.56 | $2,137.96 | $2,511.89 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $1,737.80 Typical High $2,041.74 | Professional | None | $30.20 | $1,737.80 | $2,041.74 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $1,905.46 Median $3,019.95 Typical High $144,543.98 | Facility | None | $1,905.46 | $3,019.95 | $144,543.98 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,398.83 Median $3,019.95 Typical High $169,824.37 | Professional | None | $2,398.83 | $3,019.95 | $169,824.37 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,238.72 Median $2,290.87 Typical High $3,467.37 | Facility | None | $2,238.72 | $2,290.87 | $3,467.37 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $2,511.89 | Professional | None | $1,698.24 | $1,698.24 | $2,511.89 |
Select Health Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $3,090.30 | Facility | None | $2,398.83 | $2,398.83 | $3,090.30 |
Select Health Setting Professional Modifier None Typical Low $1,548.82 Median $2,398.83 Typical High $2,630.27 | Professional | None | $1,548.82 | $2,398.83 | $2,630.27 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,071.52 Typical High $1,659.59 | Professional | None | $1,000.00 | $1,071.52 | $1,659.59 |
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 $758.58 Median $1,000.00 Typical High $1,000.00 | Professional | 52 · Reduced service | $758.58 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $309.03 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $229.09 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $151.36 | $199.53 | $199.53 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,778.28 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,778.28 | $1,862.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $758.58 Median $1,000.00 Typical High $1,000.00 | Professional | 52 · Reduced service | $758.58 | $1,000.00 | $1,000.00 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $309.03 | $398.11 | $398.11 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $229.09 | $295.12 | $295.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $151.36 | $199.53 | $199.53 |
Where Idaho sits
The same service costs 2.6 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· 12th of 51
$2,042
MT $2,512DE $977
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.