How much rates vary
Facilitymedian $42,658 · 10th to 90th $28,184 to $70,795Professionalmedian $37,154 · 10th to 90th $19,498 to $56,234
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 $28,840.32 Median $37,153.52 Typical High $37,153.52 | Professional | None | $28,840.32 | $37,153.52 | $37,153.52 |
BCBS Idaho Setting Facility Modifier None Typical Low $32,359.37 Median $42,657.95 Typical High $70,794.58 | Facility | None | $32,359.37 | $42,657.95 | $70,794.58 |
BCBS Idaho Setting Professional Modifier None Typical Low $31,622.78 Median $46,773.51 Typical High $48,977.88 | Professional | None | $31,622.78 | $46,773.51 | $48,977.88 |
Cigna Setting Facility Modifier None Typical Low $30,199.52 Median $30,199.52 Typical High $31,622.78 | Facility | None | $30,199.52 | $30,199.52 | $31,622.78 |
Cigna Setting Professional Modifier None Typical Low $22,387.21 Median $22,387.21 Typical High $30,199.52 | Professional | None | $22,387.21 | $22,387.21 | $30,199.52 |
Moda Health Setting Facility Modifier None Typical Low $12,589.25 Median $37,153.52 Typical High $44,668.36 | Facility | None | $12,589.25 | $37,153.52 | $44,668.36 |
Moda Health Setting Professional Modifier None Typical Low $28,840.32 Median $40,738.03 Typical High $46,773.51 | Professional | None | $28,840.32 | $40,738.03 | $46,773.51 |
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 $34,673.69 Median $56,234.13 Typical High $2,691,534.80 | Facility | None | $34,673.69 | $56,234.13 | $2,691,534.80 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $44,668.36 Median $56,234.13 Typical High $3,162,277.66 | Professional | None | $44,668.36 | $56,234.13 | $3,162,277.66 |
Regence BlueShield Setting Facility Modifier None Typical Low $41,686.94 Median $42,657.95 Typical High $64,565.42 | Facility | None | $41,686.94 | $42,657.95 | $64,565.42 |
Regence BlueShield Setting Professional Modifier None Typical Low $31,622.78 Median $31,622.78 Typical High $46,773.51 | Professional | None | $31,622.78 | $31,622.78 | $46,773.51 |
Select Health Setting Facility Modifier None Typical Low $43,651.58 Median $44,668.36 Typical High $57,543.99 | Facility | None | $43,651.58 | $44,668.36 | $57,543.99 |
Select Health Setting Professional Modifier None Typical Low $28,840.32 Median $44,668.36 Typical High $48,977.88 | Professional | None | $28,840.32 | $44,668.36 | $48,977.88 |
United Setting Professional Modifier None Typical Low $18,197.01 Median $19,498.45 Typical High $30,199.52 | Professional | None | $18,197.01 | $19,498.45 | $30,199.52 |
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 $14,125.38 Median $18,620.87 Typical High $18,620.87 | Professional | 52 · Reduced service | $14,125.38 | $18,620.87 | $18,620.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5,754.40 Median $7,413.10 Typical High $7,413.10 | Professional | 53 · Discontinued | $5,754.40 | $7,413.10 | $7,413.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4,265.80 Median $5,495.41 Typical High $5,495.41 | Professional | 55 · Aftercare only | $4,265.80 | $5,495.41 | $5,495.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2,884.03 Median $3,715.35 Typical High $3,715.35 | Professional | 56 · Pre-op care only | $2,884.03 | $3,715.35 | $3,715.35 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $29,512.09 Median $33,113.11 Typical High $34,673.69 | Professional | 78 · Unplanned return to OR | $29,512.09 | $33,113.11 | $34,673.69 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $14,125.38 Median $18,620.87 Typical High $18,620.87 | Professional | 52 · Reduced service | $14,125.38 | $18,620.87 | $18,620.87 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5,754.40 Median $7,413.10 Typical High $7,413.10 | Professional | 53 · Discontinued | $5,754.40 | $7,413.10 | $7,413.10 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4,265.80 Median $5,495.41 Typical High $5,495.41 | Professional | 55 · Aftercare only | $4,265.80 | $5,495.41 | $5,495.41 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2,884.03 Median $3,715.35 Typical High $3,715.35 | Professional | 56 · Pre-op care only | $2,884.03 | $3,715.35 | $3,715.35 |
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
$38,019
HI $47,863NJ $22,387
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.