How much rates vary
Facilitymedian $10,471 · 10th to 90th $6,026 to $17,378Professionalmedian $8,913 · 10th to 90th $4,677 to $13,804
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 $6,918.31 Median $8,912.51 Typical High $8,912.51 | Professional | None | $6,918.31 | $8,912.51 | $8,912.51 |
BCBS Idaho Setting Facility Modifier None Typical Low $7,762.47 Median $10,471.29 Typical High $17,378.01 | Facility | None | $7,762.47 | $10,471.29 | $17,378.01 |
BCBS Idaho Setting Professional Modifier None Typical Low $7,585.78 Median $11,481.54 Typical High $12,022.64 | Professional | None | $7,585.78 | $11,481.54 | $12,022.64 |
Cigna Setting Facility Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $7,943.28 | Facility | None | $7,585.78 | $7,585.78 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $7,585.78 | Professional | None | $5,495.41 | $5,495.41 | $7,585.78 |
Moda Health Setting Facility Modifier None Typical Low $3,019.95 Median $8,912.51 Typical High $10,964.78 | Facility | None | $3,019.95 | $8,912.51 | $10,964.78 |
Moda Health Setting Professional Modifier None Typical Low $6,918.31 Median $9,772.37 Typical High $11,481.54 | Professional | None | $6,918.31 | $9,772.37 | $11,481.54 |
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 $8,709.64 Median $13,803.84 Typical High $660,693.45 | Facility | None | $8,709.64 | $13,803.84 | $660,693.45 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $10,964.78 Median $13,803.84 Typical High $776,247.12 | Professional | None | $10,964.78 | $13,803.84 | $776,247.12 |
Regence BlueShield Setting Facility Modifier None Typical Low $10,232.93 Median $10,471.29 Typical High $15,848.93 | Facility | None | $10,232.93 | $10,471.29 | $15,848.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $11,481.54 | Professional | None | $7,585.78 | $7,585.78 | $11,481.54 |
Select Health Setting Facility Modifier None Typical Low $10,964.78 Median $10,964.78 Typical High $14,125.38 | Facility | None | $10,964.78 | $10,964.78 | $14,125.38 |
Select Health Setting Professional Modifier None Typical Low $7,079.46 Median $10,964.78 Typical High $12,022.64 | Professional | None | $7,079.46 | $10,964.78 | $12,022.64 |
United Setting Facility Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,786.30 | Facility | None | $4,265.80 | $4,265.80 | $4,786.30 |
United Setting Professional Modifier None Typical Low $4,365.16 Median $4,677.35 Typical High $7,244.36 | Professional | None | $4,365.16 | $4,677.35 | $7,244.36 |
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 $3,467.37 Median $4,466.84 Typical High $4,466.84 | Professional | 52 · Reduced service | $3,467.37 | $4,466.84 | $4,466.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,380.38 Median $1,819.70 Typical High $1,819.70 | Professional | 53 · Discontinued | $1,380.38 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,047.13 Median $1,348.96 Typical High $1,348.96 | Professional | 55 · Aftercare only | $1,047.13 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $691.83 Median $891.25 Typical High $891.25 | Professional | 56 · Pre-op care only | $691.83 | $891.25 | $891.25 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $7,079.46 Median $7,943.28 Typical High $8,317.64 | Professional | 78 · Unplanned return to OR | $7,079.46 | $7,943.28 | $8,317.64 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $3,467.37 Median $4,466.84 Typical High $4,466.84 | Professional | 52 · Reduced service | $3,467.37 | $4,466.84 | $4,466.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1,380.38 Median $1,819.70 Typical High $1,819.70 | Professional | 53 · Discontinued | $1,380.38 | $1,819.70 | $1,819.70 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1,047.13 Median $1,348.96 Typical High $1,348.96 | Professional | 55 · Aftercare only | $1,047.13 | $1,348.96 | $1,348.96 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $691.83 Median $891.25 Typical High $891.25 | Professional | 56 · Pre-op care only | $691.83 | $891.25 | $891.25 |
Where Idaho sits
The same service costs 2.1 times more in Montana than in Pennsylvania. 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
$9,120
MT $11,220PA $5,370
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.