How much rates vary
Facilitymedian $891 · 10th to 90th $240 to $2,818Professionalmedian $741 · 10th to 90th $372 to $1,122
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 Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Facility | None | $870.96 | $870.96 | $870.96 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $741.31 Typical High $741.31 | Professional | None | $562.34 | $741.31 | $741.31 |
BCBS Idaho Setting Facility Modifier None Typical Low $741.31 Median $1,412.54 Typical High $2,187.76 | Facility | None | $741.31 | $1,412.54 | $2,187.76 |
BCBS Idaho Setting Professional Modifier None Typical Low $630.96 Median $933.25 Typical High $977.24 | Professional | None | $630.96 | $933.25 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $691.83 | Facility | None | $660.69 | $660.69 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $660.69 | Professional | None | $562.34 | $562.34 | $660.69 |
Moda Health Setting Facility Modifier None Typical Low $239.88 Median $741.31 Typical High $1,047.13 | Facility | None | $239.88 | $741.31 | $1,047.13 |
Moda Health Setting Professional Modifier None Typical Low $562.34 Median $812.83 Typical High $933.25 | Professional | None | $562.34 | $812.83 | $933.25 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $645.65 Typical High $758.58 | Professional | None | $30.20 | $645.65 | $758.58 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $707.95 Median $1,122.02 Typical High $53,703.18 | Facility | None | $707.95 | $1,122.02 | $53,703.18 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $891.25 Median $1,122.02 Typical High $63,095.73 | Professional | None | $891.25 | $1,122.02 | $63,095.73 |
Regence BlueShield Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $933.25 | Professional | None | $630.96 | $630.96 | $933.25 |
Select Health Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $2,818.38 | Facility | None | $891.25 | $891.25 | $2,818.38 |
Select Health Setting Professional Modifier None Typical Low $575.44 Median $891.25 Typical High $977.24 | Professional | None | $575.44 | $891.25 | $977.24 |
United Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
United Setting Professional Modifier None Typical Low $346.74 Median $371.54 Typical High $575.44 | Professional | None | $346.74 | $371.54 | $575.44 |
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 $281.84 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $281.84 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $114.82 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $85.11 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $56.23 | $74.13 | $74.13 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $660.69 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $588.84 | $660.69 | $691.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $281.84 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $281.84 | $371.54 | $371.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $114.82 | $147.91 | $147.91 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $85.11 | $109.65 | $109.65 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $56.23 | $74.13 | $74.13 |
Where Idaho sits
The same service costs 2.5 times more in Montana than in Washington, DC. 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
$741
MT $1,047DC $417
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.