How much rates vary
Facilitymedian $16,982 · 10th to 90th $11,482 to $28,184Professionalmedian $14,791 · 10th to 90th $8,710 to $22,387
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 $11,481.54 Median $14,791.08 Typical High $14,791.08 | Professional | None | $11,481.54 | $14,791.08 | $14,791.08 |
BCBS Idaho Setting Facility Modifier None Typical Low $13,489.63 Median $16,982.44 Typical High $28,183.83 | Facility | None | $13,489.63 | $16,982.44 | $28,183.83 |
BCBS Idaho Setting Professional Modifier None Typical Low $12,589.25 Median $18,620.87 Typical High $19,498.45 | Professional | None | $12,589.25 | $18,620.87 | $19,498.45 |
Cigna Setting Facility Modifier None Typical Low $12,589.25 Median $12,589.25 Typical High $13,182.57 | Facility | None | $12,589.25 | $12,589.25 | $13,182.57 |
Cigna Setting Professional Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $12,589.25 | Professional | None | $9,120.11 | $9,120.11 | $12,589.25 |
Moda Health Setting Facility Modifier None Typical Low $5,623.41 Median $14,791.08 Typical High $17,782.79 | Facility | None | $5,623.41 | $14,791.08 | $17,782.79 |
Moda Health Setting Professional Modifier None Typical Low $11,481.54 Median $16,218.10 Typical High $18,620.87 | Professional | None | $11,481.54 | $16,218.10 | $18,620.87 |
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 $14,125.38 Median $22,387.21 Typical High $1,071,519.31 | Facility | None | $14,125.38 | $22,387.21 | $1,071,519.31 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $17,782.79 Median $22,387.21 Typical High $1,258,925.41 | Professional | None | $17,782.79 | $22,387.21 | $1,258,925.41 |
Regence BlueShield Setting Facility Modifier None Typical Low $16,595.87 Median $16,982.44 Typical High $25,703.96 | Facility | None | $16,595.87 | $16,982.44 | $25,703.96 |
Regence BlueShield Setting Professional Modifier None Typical Low $12,589.25 Median $12,589.25 Typical High $18,620.87 | Professional | None | $12,589.25 | $12,589.25 | $18,620.87 |
Select Health Setting Facility Modifier None Typical Low $17,782.79 Median $17,782.79 Typical High $22,908.68 | Facility | None | $17,782.79 | $17,782.79 | $22,908.68 |
Select Health Setting Professional Modifier None Typical Low $11,481.54 Median $17,782.79 Typical High $19,498.45 | Professional | None | $11,481.54 | $17,782.79 | $19,498.45 |
United Setting Facility Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $9,332.54 | Facility | None | $7,943.28 | $7,943.28 | $9,332.54 |
United Setting Professional Modifier None Typical Low $8,128.31 Median $8,709.64 Typical High $13,489.63 | Professional | None | $8,128.31 | $8,709.64 | $13,489.63 |
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 $5,623.41 Median $7,413.10 Typical High $7,413.10 | Professional | 52 · Reduced service | $5,623.41 | $7,413.10 | $7,413.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2,290.87 Median $2,951.21 Typical High $2,951.21 | Professional | 53 · Discontinued | $2,290.87 | $2,951.21 | $2,951.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,698.24 Median $2,187.76 Typical High $2,187.76 | Professional | 55 · Aftercare only | $1,698.24 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1,148.15 Median $1,479.11 Typical High $1,479.11 | Professional | 56 · Pre-op care only | $1,148.15 | $1,479.11 | $1,479.11 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $11,748.98 Median $13,182.57 Typical High $13,803.84 | Professional | 78 · Unplanned return to OR | $11,748.98 | $13,182.57 | $13,803.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $5,623.41 Median $7,413.10 Typical High $7,413.10 | Professional | 52 · Reduced service | $5,623.41 | $7,413.10 | $7,413.10 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2,290.87 Median $2,951.21 Typical High $2,951.21 | Professional | 53 · Discontinued | $2,290.87 | $2,951.21 | $2,951.21 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1,698.24 Median $2,187.76 Typical High $2,187.76 | Professional | 55 · Aftercare only | $1,698.24 | $2,187.76 | $2,187.76 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1,148.15 Median $1,479.11 Typical High $1,479.11 | Professional | 56 · Pre-op care only | $1,148.15 | $1,479.11 | $1,479.11 |
Where Idaho sits
The same service costs 2.5 times more in Montana than in Florida. 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· 15th of 51
$15,136
MT $22,387FL $9,120
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.