How much rates vary
Facilitymedian $3,981 · 10th to 90th $2,291 to $6,761Professionalmedian $3,467 · 10th to 90th $1,549 to $5,248
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 $2,691.53 Median $3,467.37 Typical High $3,467.37 | Professional | None | $2,691.53 | $3,467.37 | $3,467.37 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,019.95 Median $4,073.80 Typical High $6,760.83 | Facility | None | $3,019.95 | $4,073.80 | $6,760.83 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,951.21 Median $4,466.84 Typical High $4,677.35 | Professional | None | $2,951.21 | $4,466.84 | $4,677.35 |
Cigna Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,630.27 | Facility | None | $2,454.71 | $2,454.71 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,454.71 | Professional | None | $1,819.70 | $1,819.70 | $2,454.71 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $3,467.37 Typical High $4,265.80 | Facility | None | $1,000.00 | $3,467.37 | $4,265.80 |
Moda Health Setting Professional Modifier None Typical Low $2,691.53 Median $3,801.89 Typical High $4,466.84 | Professional | None | $2,691.53 | $3,801.89 | $4,466.84 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $3,019.95 Typical High $3,548.13 | Professional | None | $30.20 | $3,019.95 | $3,548.13 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $2,754.23 Median $5,248.07 Typical High $251,188.64 | Facility | None | $2,754.23 | $5,248.07 | $251,188.64 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $4,265.80 Median $5,248.07 Typical High $295,120.92 | Professional | None | $4,265.80 | $5,248.07 | $295,120.92 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,981.07 Median $4,073.80 Typical High $6,025.60 | Facility | None | $3,981.07 | $4,073.80 | $6,025.60 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $4,466.84 | Professional | None | $2,951.21 | $2,951.21 | $4,466.84 |
Select Health Setting Facility Modifier None Typical Low $3,890.45 Median $4,265.80 Typical High $5,370.32 | Facility | None | $3,890.45 | $4,265.80 | $5,370.32 |
Select Health Setting Professional Modifier None Typical Low $2,754.23 Median $4,265.80 Typical High $4,466.84 | Professional | None | $2,754.23 | $4,265.80 | $4,466.84 |
United Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,187.76 | Facility | None | $2,089.30 | $2,089.30 | $2,187.76 |
United Setting Professional Modifier None Typical Low $1,445.44 Median $1,548.82 Typical High $2,398.83 | Professional | None | $1,445.44 | $1,548.82 | $2,398.83 |
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 $1,348.96 Median $1,737.80 Typical High $1,737.80 | Professional | 52 · Reduced service | $1,348.96 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $537.03 Median $691.83 Typical High $691.83 | Professional | 53 · Discontinued | $537.03 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $524.81 Typical High $524.81 | Professional | 55 · Aftercare only | $407.38 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $269.15 Median $346.74 Typical High $346.74 | Professional | 56 · Pre-op care only | $269.15 | $346.74 | $346.74 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,754.23 Median $3,090.30 Typical High $3,235.94 | Professional | 78 · Unplanned return to OR | $2,754.23 | $3,090.30 | $3,235.94 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,348.96 Median $1,737.80 Typical High $1,737.80 | Professional | 52 · Reduced service | $1,348.96 | $1,737.80 | $1,737.80 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $537.03 Median $691.83 Typical High $691.83 | Professional | 53 · Discontinued | $537.03 | $691.83 | $691.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $524.81 Typical High $524.81 | Professional | 55 · Aftercare only | $407.38 | $524.81 | $524.81 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $269.15 Median $346.74 Typical High $346.74 | Professional | 56 · Pre-op care only | $269.15 | $346.74 | $346.74 |
Where Idaho sits
The same service costs 3.4 times more in Hawaii 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· 8th of 51
$3,467
HI $5,623DC $1,660
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.