How much rates vary
Facilitymedian $10,000 · 10th to 90th $5,754 to $16,596Professionalmedian $8,511 · 10th to 90th $4,571 to $12,882
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 $6,606.93 Median $8,511.38 Typical High $8,511.38 | Professional | None | $6,606.93 | $8,511.38 | $8,511.38 |
BCBS Idaho Setting Facility Modifier None Typical Low $7,413.10 Median $10,000.00 Typical High $16,595.87 | Facility | None | $7,413.10 | $10,000.00 | $16,595.87 |
BCBS Idaho Setting Professional Modifier None Typical Low $7,244.36 Median $10,964.78 Typical High $11,481.54 | Professional | None | $7,244.36 | $10,964.78 | $11,481.54 |
Cigna Setting Facility Modifier None Typical Low $7,244.36 Median $7,244.36 Typical High $7,585.78 | Facility | None | $7,244.36 | $7,244.36 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $7,244.36 | Professional | None | $5,248.07 | $5,248.07 | $7,244.36 |
Moda Health Setting Facility Modifier None Typical Low $2,951.21 Median $8,511.38 Typical High $10,471.29 | Facility | None | $2,951.21 | $8,511.38 | $10,471.29 |
Moda Health Setting Professional Modifier None Typical Low $6,606.93 Median $9,332.54 Typical High $10,964.78 | Professional | None | $6,606.93 | $9,332.54 | $10,964.78 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $8,317.64 Median $12,882.50 Typical High $630,957.34 | Facility | None | $8,317.64 | $12,882.50 | $630,957.34 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $10,964.78 Median $12,882.50 Typical High $741,310.24 | Professional | None | $10,964.78 | $12,882.50 | $741,310.24 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,772.37 Median $10,000.00 Typical High $14,791.08 | Facility | None | $9,772.37 | $10,000.00 | $14,791.08 |
Regence BlueShield Setting Professional Modifier None Typical Low $7,244.36 Median $7,244.36 Typical High $10,964.78 | Professional | None | $7,244.36 | $7,244.36 | $10,964.78 |
Select Health Setting Facility Modifier None Typical Low $10,471.29 Median $10,471.29 Typical High $13,489.63 | Facility | None | $10,471.29 | $10,471.29 | $13,489.63 |
Select Health Setting Professional Modifier None Typical Low $6,760.83 Median $10,471.29 Typical High $11,481.54 | Professional | None | $6,760.83 | $10,471.29 | $11,481.54 |
United Setting Facility Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $5,128.61 | Facility | None | $4,365.16 | $4,365.16 | $5,128.61 |
United Setting Professional Modifier None Typical Low $4,265.80 Median $4,570.88 Typical High $7,079.46 | Professional | None | $4,265.80 | $4,570.88 | $7,079.46 |
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 $3,311.31 Median $4,265.80 Typical High $4,265.80 | Professional | 52 · Reduced service | $3,311.31 | $4,265.80 | $4,265.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,318.26 Median $1,698.24 Typical High $1,698.24 | Professional | 53 · Discontinued | $1,318.26 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,000.00 Median $1,288.25 Typical High $1,288.25 | Professional | 55 · Aftercare only | $1,000.00 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $660.69 Median $851.14 Typical High $851.14 | Professional | 56 · Pre-op care only | $660.69 | $851.14 | $851.14 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $6,760.83 Median $7,585.78 Typical High $7,943.28 | Professional | 78 · Unplanned return to OR | $6,760.83 | $7,585.78 | $7,943.28 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $3,311.31 Median $4,265.80 Typical High $4,265.80 | Professional | 52 · Reduced service | $3,311.31 | $4,265.80 | $4,265.80 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1,318.26 Median $1,698.24 Typical High $1,698.24 | Professional | 53 · Discontinued | $1,318.26 | $1,698.24 | $1,698.24 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1,000.00 Median $1,288.25 Typical High $1,288.25 | Professional | 55 · Aftercare only | $1,000.00 | $1,288.25 | $1,288.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $660.69 Median $851.14 Typical High $851.14 | Professional | 56 · Pre-op care only | $660.69 | $851.14 | $851.14 |
Where Idaho sits
The same service costs 2.1 times more in Hawaii than in New Jersey. 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
$8,913
HI $11,220NJ $5,248
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.