How much rates vary
Facilitymedian $13,183 · 10th to 90th $8,511 to $21,878Professionalmedian $11,220 · 10th to 90th $6,166 to $16,982
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 $8,709.64 Median $11,220.18 Typical High $11,220.18 | Professional | None | $8,709.64 | $11,220.18 | $11,220.18 |
BCBS Idaho Setting Facility Modifier None Typical Low $9,772.37 Median $13,182.57 Typical High $21,877.62 | Facility | None | $9,772.37 | $13,182.57 | $21,877.62 |
BCBS Idaho Setting Professional Modifier None Typical Low $9,549.93 Median $14,454.40 Typical High $15,135.61 | Professional | None | $9,549.93 | $14,454.40 | $15,135.61 |
Cigna Setting Facility Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $9,549.93 | Facility | None | $9,120.11 | $9,120.11 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $9,120.11 | Professional | None | $6,606.93 | $6,606.93 | $9,120.11 |
Moda Health Setting Facility Modifier None Typical Low $3,981.07 Median $11,220.18 Typical High $13,803.84 | Facility | None | $3,981.07 | $11,220.18 | $13,803.84 |
Moda Health Setting Professional Modifier None Typical Low $8,709.64 Median $12,302.69 Typical High $14,454.40 | Professional | None | $8,709.64 | $12,302.69 | $14,454.40 |
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 $10,964.78 Median $16,982.44 Typical High $831,763.77 | Facility | None | $10,964.78 | $16,982.44 | $831,763.77 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $13,803.84 Median $16,982.44 Typical High $954,992.59 | Professional | None | $13,803.84 | $16,982.44 | $954,992.59 |
Regence BlueShield Setting Facility Modifier None Typical Low $12,882.50 Median $13,182.57 Typical High $19,498.45 | Facility | None | $12,882.50 | $13,182.57 | $19,498.45 |
Regence BlueShield Setting Professional Modifier None Typical Low $9,549.93 Median $9,549.93 Typical High $14,454.40 | Professional | None | $9,549.93 | $9,549.93 | $14,454.40 |
Select Health Setting Facility Modifier None Typical Low $13,803.84 Median $13,803.84 Typical High $17,782.79 | Facility | None | $13,803.84 | $13,803.84 | $17,782.79 |
Select Health Setting Professional Modifier None Typical Low $8,912.51 Median $13,803.84 Typical High $15,135.61 | Professional | None | $8,912.51 | $13,803.84 | $15,135.61 |
United Setting Facility Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $6,165.95 | Facility | None | $5,128.61 | $5,128.61 | $6,165.95 |
United Setting Professional Modifier None Typical Low $5,623.41 Median $6,165.95 Typical High $9,332.54 | Professional | None | $5,623.41 | $6,165.95 | $9,332.54 |
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 $4,365.16 Median $5,623.41 Typical High $5,623.41 | Professional | 52 · Reduced service | $4,365.16 | $5,623.41 | $5,623.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,737.80 Median $2,238.72 Typical High $2,238.72 | Professional | 53 · Discontinued | $1,737.80 | $2,238.72 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,318.26 Median $1,698.24 Typical High $1,698.24 | Professional | 55 · Aftercare only | $1,318.26 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $870.96 Median $1,122.02 Typical High $1,122.02 | Professional | 56 · Pre-op care only | $870.96 | $1,122.02 | $1,122.02 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $8,912.51 Median $10,000.00 Typical High $10,471.29 | Professional | 78 · Unplanned return to OR | $8,912.51 | $10,000.00 | $10,471.29 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $4,365.16 Median $5,623.41 Typical High $5,623.41 | Professional | 52 · Reduced service | $4,365.16 | $5,623.41 | $5,623.41 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1,737.80 Median $2,238.72 Typical High $2,238.72 | Professional | 53 · Discontinued | $1,737.80 | $2,238.72 | $2,238.72 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1,318.26 Median $1,698.24 Typical High $1,698.24 | Professional | 55 · Aftercare only | $1,318.26 | $1,698.24 | $1,698.24 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $870.96 Median $1,122.02 Typical High $1,122.02 | Professional | 56 · Pre-op care only | $870.96 | $1,122.02 | $1,122.02 |
Where Idaho sits
The same service costs 2.5 times more in Montana than in Delaware. 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· 10th of 51
$11,749
MT $16,596DE $6,607
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.