How much rates vary
Facilitymedian $4,169 · 10th to 90th $2,692 to $6,918Professionalmedian $3,548 · 10th to 90th $1,862 to $5,495
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 $2,754.23 Median $3,548.13 Typical High $3,548.13 | Professional | None | $2,754.23 | $3,548.13 | $3,548.13 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,090.30 Median $4,168.69 Typical High $6,918.31 | Facility | None | $3,090.30 | $4,168.69 | $6,918.31 |
BCBS Idaho Setting Professional Modifier None Typical Low $3,019.95 Median $4,570.88 Typical High $4,786.30 | Professional | None | $3,019.95 | $4,570.88 | $4,786.30 |
Cigna Setting Facility Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $3,090.30 | Facility | None | $2,951.21 | $2,951.21 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,951.21 | Professional | None | $2,187.76 | $2,187.76 | $2,951.21 |
Moda Health Setting Facility Modifier None Typical Low $1,202.26 Median $3,548.13 Typical High $4,365.16 | Facility | None | $1,202.26 | $3,548.13 | $4,365.16 |
Moda Health Setting Professional Modifier None Typical Low $2,754.23 Median $3,890.45 Typical High $4,570.88 | Professional | None | $2,754.23 | $3,890.45 | $4,570.88 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $3,162.28 Typical High $3,715.35 | Professional | None | $30.20 | $3,162.28 | $3,715.35 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $3,467.37 Median $5,495.41 Typical High $263,026.80 | Facility | None | $3,467.37 | $5,495.41 | $263,026.80 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $4,365.16 Median $5,495.41 Typical High $309,029.54 | Professional | None | $4,365.16 | $5,495.41 | $309,029.54 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,073.80 Median $4,168.69 Typical High $6,309.57 | Facility | None | $4,073.80 | $4,168.69 | $6,309.57 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $4,570.88 | Professional | None | $3,019.95 | $3,019.95 | $4,570.88 |
Select Health Setting Facility Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $5,623.41 | Facility | None | $4,365.16 | $4,365.16 | $5,623.41 |
Select Health Setting Professional Modifier None Typical Low $2,818.38 Median $4,365.16 Typical High $4,786.30 | Professional | None | $2,818.38 | $4,365.16 | $4,786.30 |
United Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,951.21 | Facility | None | $2,041.74 | $2,041.74 | $2,951.21 |
United Setting Professional Modifier None Typical Low $1,698.24 Median $1,862.09 Typical High $2,818.38 | Professional | None | $1,698.24 | $1,862.09 | $2,818.38 |
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 $1,380.38 Median $1,778.28 Typical High $1,778.28 | Professional | 52 · Reduced service | $1,380.38 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $724.44 Typical High $724.44 | Professional | 53 · Discontinued | $549.54 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $537.03 Typical High $537.03 | Professional | 55 · Aftercare only | $416.87 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $354.81 Typical High $354.81 | Professional | 56 · Pre-op care only | $275.42 | $354.81 | $354.81 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,818.38 Median $3,162.28 Typical High $3,388.44 | Professional | 78 · Unplanned return to OR | $2,818.38 | $3,162.28 | $3,388.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,380.38 Median $1,778.28 Typical High $1,778.28 | Professional | 52 · Reduced service | $1,380.38 | $1,778.28 | $1,778.28 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $724.44 Typical High $724.44 | Professional | 53 · Discontinued | $549.54 | $724.44 | $724.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $537.03 Typical High $537.03 | Professional | 55 · Aftercare only | $416.87 | $537.03 | $537.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $354.81 Typical High $354.81 | Professional | 56 · Pre-op care only | $275.42 | $354.81 | $354.81 |
Where Idaho sits
The same service costs 2.5 times more in Montana 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
$3,715
MT $4,898DC $1,995
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.