How much rates vary
Facilitymedian $2,692 · 10th to 90th $1,585 to $4,571Professionalmedian $2,344 · 10th to 90th $1,148 to $3,548
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 $1,819.70 Median $2,344.23 Typical High $2,344.23 | Professional | None | $1,819.70 | $2,344.23 | $2,344.23 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,187.76 Median $2,754.23 Typical High $4,570.88 | Facility | None | $2,187.76 | $2,754.23 | $4,570.88 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,995.26 Median $3,019.95 Typical High $3,162.28 | Professional | None | $1,995.26 | $3,019.95 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,041.74 | Facility | None | $1,949.84 | $1,949.84 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,949.84 | Professional | None | $1,445.44 | $1,445.44 | $1,949.84 |
Moda Health Setting Facility Modifier None Typical Low $741.31 Median $2,344.23 Typical High $2,884.03 | Facility | None | $741.31 | $2,344.23 | $2,884.03 |
Moda Health Setting Professional Modifier None Typical Low $1,819.70 Median $2,570.40 Typical High $3,019.95 | Professional | None | $1,819.70 | $2,570.40 | $3,019.95 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $2,041.74 Typical High $2,398.83 | Professional | None | $30.20 | $2,041.74 | $2,398.83 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $169,824.37 | Facility | None | $1,949.84 | $3,548.13 | $169,824.37 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,884.03 Median $3,548.13 Typical High $199,526.23 | Professional | None | $2,884.03 | $3,548.13 | $199,526.23 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,691.53 Median $2,754.23 Typical High $4,073.80 | Facility | None | $2,691.53 | $2,754.23 | $4,073.80 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $3,019.95 | Professional | None | $1,995.26 | $1,995.26 | $3,019.95 |
Select Health Setting Facility Modifier None Typical Low $2,630.27 Median $2,884.03 Typical High $3,630.78 | Facility | None | $2,630.27 | $2,884.03 | $3,630.78 |
Select Health Setting Professional Modifier None Typical Low $1,862.09 Median $2,884.03 Typical High $3,162.28 | Professional | None | $1,862.09 | $2,884.03 | $3,162.28 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,258.93 | Facility | None | $1,096.48 | $1,096.48 | $1,258.93 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,148.15 Typical High $1,778.28 | Professional | None | $1,071.52 | $1,148.15 | $1,778.28 |
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 $912.01 Median $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $912.01 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $467.74 Typical High $467.74 | Professional | 53 · Discontinued | $363.08 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $275.42 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $181.97 | $234.42 | $234.42 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $2,089.30 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $1,862.09 | $2,089.30 | $2,187.76 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $912.01 Median $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $912.01 | $1,174.90 | $1,174.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $467.74 Typical High $467.74 | Professional | 53 · Discontinued | $363.08 | $467.74 | $467.74 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $275.42 | $354.81 | $354.81 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $181.97 | $234.42 | $234.42 |
Where Idaho sits
The same service costs 2.4 times more in Minnesota than in Washington, DC. 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
$2,344
MN $2,951DC $1,230
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.