How much rates vary
Facilitymedian $2,291 · 10th to 90th $759 to $95,499Professionalmedian $2,138 · 10th to 90th $1,175 to $3,236
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 $1,659.59 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,659.59 | $2,137.96 | $2,137.96 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,995.26 Median $2,454.71 Typical High $4,365.16 | Facility | None | $1,995.26 | $2,454.71 | $4,365.16 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,819.70 Median $2,754.23 Typical High $2,884.03 | Professional | None | $1,819.70 | $2,754.23 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,584.89 | Facility | None | $1,479.11 | $1,479.11 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,479.11 | Professional | None | $1,258.93 | $1,258.93 | $1,479.11 |
Moda Health Setting Facility Modifier None Typical Low $758.58 Median $2,137.96 Typical High $2,630.27 | Facility | None | $758.58 | $2,137.96 | $2,630.27 |
Moda Health Setting Professional Modifier None Typical Low $1,659.59 Median $2,344.23 Typical High $2,754.23 | Professional | None | $1,659.59 | $2,344.23 | $2,754.23 |
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 $2,089.30 Median $3,235.94 Typical High $154,881.66 | Facility | None | $2,089.30 | $3,235.94 | $154,881.66 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,630.27 Median $3,235.94 Typical High $181,970.09 | Professional | None | $2,630.27 | $3,235.94 | $181,970.09 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,754.23 | Professional | None | $1,819.70 | $1,819.70 | $2,754.23 |
Select Health Setting Facility Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,691.53 | Facility | None | $2,630.27 | $2,630.27 | $2,691.53 |
Select Health Setting Professional Modifier None Typical Low $1,698.24 Median $2,630.27 Typical High $2,884.03 | Professional | None | $1,698.24 | $2,630.27 | $2,884.03 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,174.90 Typical High $1,819.70 | Professional | None | $1,096.48 | $1,174.90 | $1,819.70 |
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 $831.76 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $831.76 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $331.13 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $251.19 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $165.96 | $213.80 | $213.80 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,905.46 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,905.46 | $1,995.26 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $831.76 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $831.76 | $1,071.52 | $1,071.52 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $331.13 | $426.58 | $426.58 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $251.19 | $323.59 | $323.59 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $165.96 | $213.80 | $213.80 |
Where Idaho sits
The same service costs 2.6 times more in Montana than in New York. 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
$2,138
MT $2,754NY $1,072
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.