How much rates vary
Facilitymedian $49 · 10th to 90th $6 to $120Professionalmedian $6 · 10th to 90th $5 to $8
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 $7.08 Median $7.08 Typical High $7.59 | Facility | None | $7.08 | $7.08 | $7.59 |
Aetna Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $6.61 | Professional | None | $5.89 | $5.89 | $6.61 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.95 Median $2.95 Typical High $3.31 | Professional | 52 · Reduced service | $2.95 | $2.95 | $3.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.20 Median $1.20 Typical High $1.32 | Professional | 53 · Discontinued | $1.20 | $1.20 | $1.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.89 Median $0.89 Typical High $1.00 | Professional | 55 · Aftercare only | $0.89 | $0.89 | $1.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.59 Median $0.59 Typical High $0.68 | Professional | 56 · Pre-op care only | $0.59 | $0.59 | $0.68 |
BCBS Idaho Setting Facility Modifier None Typical Low $38.90 Median $72.44 Typical High $131.83 | Facility | None | $38.90 | $72.44 | $131.83 |
BCBS Idaho Setting Professional Modifier None Typical Low $4.57 Median $6.03 Typical High $6.92 | Professional | None | $4.57 | $6.03 | $6.92 |
Cigna Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $7.08 | Professional | None | $3.02 | $3.02 | $7.08 |
Moda Health Setting Facility Modifier None Typical Low $5.89 Median $7.08 Typical High $40.74 | Facility | None | $5.89 | $7.08 | $40.74 |
Moda Health Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $7.76 | Professional | None | $5.89 | $5.89 | $7.76 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2.95 Median $2.95 Typical High $3.31 | Professional | 52 · Reduced service | $2.95 | $2.95 | $3.31 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.20 Median $1.20 Typical High $1.32 | Professional | 53 · Discontinued | $1.20 | $1.20 | $1.32 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.89 Median $0.89 Typical High $1.00 | Professional | 55 · Aftercare only | $0.89 | $0.89 | $1.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.59 Median $0.59 Typical High $0.68 | Professional | 56 · Pre-op care only | $0.59 | $0.59 | $0.68 |
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 $7.59 Median $8.51 Typical High $8.51 | Facility | None | $7.59 | $8.51 | $8.51 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $8.51 Median $8.71 Typical High $8.71 | Professional | None | $8.51 | $8.71 | $8.71 |
Regence BlueShield Setting Facility Modifier None Typical Low $66.07 Median $93.33 Typical High $131.83 | Facility | None | $66.07 | $93.33 | $131.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $4.57 Median $4.57 Typical High $7.76 | Professional | None | $4.57 | $4.57 | $7.76 |
Select Health Setting Facility Modifier None Typical Low $4.47 Median $4.47 Typical High $4.68 | Facility | None | $4.47 | $4.47 | $4.68 |
Select Health Setting Professional Modifier None Typical Low $3.72 Median $4.47 Typical High $6.76 | Professional | None | $3.72 | $4.47 | $6.76 |
United Setting Professional Modifier None Typical Low $5.25 Median $6.61 Typical High $8.91 | Professional | None | $5.25 | $6.61 | $8.91 |
2 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 |
|---|---|---|---|---|---|
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3.89 Median $3.89 Typical High $6.76 | Professional | 78 · Unplanned return to OR | $3.89 | $3.89 | $6.76 |
Moda Health Setting Professional Modifier 59 · Distinct service Typical Low $5.89 Median $8.32 Typical High $25.70 | Professional | 59 · Distinct service | $5.89 | $8.32 | $25.70 |
Where Idaho sits
The same service costs 2.7 times more in North Dakota than in New Mexico. 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
$5.89
ND $8.71NM $3.24
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.