How much rates vary
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 $19.05 Median $21.88 Typical High $48.98 | Facility | None | $19.05 | $21.88 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $16.60 Median $18.20 Typical High $22.91 | Professional | None | $16.60 | $18.20 | $22.91 |
BCBS Idaho Setting Facility Modifier None Typical Low $63.10 Median $91.20 Typical High $154.88 | Facility | None | $63.10 | $91.20 | $154.88 |
BCBS Idaho Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $23.99 | Professional | None | $17.78 | $17.78 | $23.99 |
Cigna Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $22.39 | Professional | None | $13.18 | $13.18 | $22.39 |
Moda Health Setting Facility Modifier None Typical Low $19.95 Median $109.65 Typical High $537.03 | Facility | None | $19.95 | $109.65 | $537.03 |
Moda Health Setting Professional Modifier None Typical Low $13.18 Median $19.50 Typical High $28.18 | Professional | None | $13.18 | $19.50 | $28.18 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $18.20 Median $19.95 Typical High $19.95 | Facility | None | $18.20 | $19.95 | $19.95 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2.63 Median $19.50 Typical High $19.95 | Professional | None | $2.63 | $19.50 | $19.95 |
Regence BlueShield Setting Facility Modifier None Typical Low $66.07 Median $95.50 Typical High $131.83 | Facility | None | $66.07 | $95.50 | $131.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $19.50 | Professional | None | $17.78 | $17.78 | $19.50 |
Select Health Setting Facility Modifier None Typical Low $10.72 Median $10.72 Typical High $524.81 | Facility | None | $10.72 | $10.72 | $524.81 |
Select Health Setting Professional Modifier None Typical Low $10.72 Median $14.45 Typical High $23.99 | Professional | None | $10.72 | $14.45 | $23.99 |
United Setting Professional Modifier None Typical Low $15.85 Median $21.38 Typical High $28.18 | Professional | None | $15.85 | $21.38 | $28.18 |
5 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 $9.12 Median $9.12 Typical High $11.48 | Professional | 52 · Reduced service | $9.12 | $9.12 | $11.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $3.63 Typical High $4.57 | Professional | 53 · Discontinued | $3.63 | $3.63 | $4.57 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $12.59 Median $16.60 Typical High $17.38 | Professional | 78 · Unplanned return to OR | $12.59 | $16.60 | $17.38 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $9.12 Median $9.12 Typical High $11.48 | Professional | 52 · Reduced service | $9.12 | $9.12 | $11.48 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $3.63 Typical High $4.57 | Professional | 53 · Discontinued | $3.63 | $3.63 | $4.57 |
Where Idaho sits
The same service costs 3.0 times more in Minnesota than in Kentucky. 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· 20th of 51
$18.20
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.