How much rates vary
Facilitymedian $1 · 10th to 90th $0 to $20Professionalmedian $1 · 10th to 90th $0 to $20
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 $0.25 Median $0.71 Typical High $0.71 | Professional | None | $0.25 | $0.71 | $0.71 |
Aetna Setting Professional Modifier RR · Rental Typical Low $0.03 Median $0.07 Typical High $0.07 | Professional | RR · Rental | $0.03 | $0.07 | $0.07 |
BCBS Idaho Setting Facility Modifier None Typical Low $0.41 Median $0.54 Typical High $1.02 | Facility | None | $0.41 | $0.54 | $1.02 |
BCBS Idaho Setting Professional Modifier None Typical Low $0.38 Median $0.56 Typical High $0.59 | Professional | None | $0.38 | $0.56 | $0.59 |
Cigna Setting Professional Modifier None Typical Low $0.31 Median $0.31 Typical High $0.31 | Professional | None | $0.31 | $0.31 | $0.31 |
Moda Health Setting Facility Modifier None Typical Low $0.48 Median $0.51 Typical High $0.71 | Facility | None | $0.48 | $0.51 | $0.71 |
Moda Health Setting Professional Modifier None Typical Low $0.29 Median $0.58 Typical High $0.71 | Professional | None | $0.29 | $0.58 | $0.71 |
Moda Health Setting Professional Modifier RR · Rental Typical Low $0.03 Median $0.07 Typical High $0.07 | Professional | RR · Rental | $0.03 | $0.07 | $0.07 |
Molina Setting Professional Modifier None Typical Low $0.32 Median $0.46 Typical High $30.20 | Professional | None | $0.32 | $0.46 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $0.68 Median $19.95 Typical High $32.36 | Facility | None | $0.68 | $19.95 | $32.36 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $0.56 Median $0.68 Typical High $38.02 | Professional | None | $0.56 | $0.68 | $38.02 |
Regence BlueShield Setting Professional Modifier None Typical Low $0.38 Median $0.38 Typical High $0.56 | Professional | None | $0.38 | $0.38 | $0.56 |
Select Health Setting Facility Modifier None Typical Low $0.54 Median $0.54 Typical High $0.69 | Facility | None | $0.54 | $0.54 | $0.69 |
Select Health Setting Professional Modifier None Typical Low $0.54 Median $0.59 Typical High $1.26 | Professional | None | $0.54 | $0.59 | $1.26 |
United Setting Professional Modifier None Typical Low $0.21 Median $0.26 Typical High $0.41 | Professional | None | $0.21 | $0.26 | $0.41 |
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 $0.15 Median $0.36 Typical High $0.36 | Professional | 52 · Reduced service | $0.15 | $0.36 | $0.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.06 Median $0.14 Typical High $0.14 | Professional | 53 · Discontinued | $0.06 | $0.14 | $0.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.04 Median $0.11 Typical High $0.11 | Professional | 55 · Aftercare only | $0.04 | $0.11 | $0.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.07 Typical High $0.07 | Professional | 56 · Pre-op care only | $0.03 | $0.07 | $0.07 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $0.35 Median $0.40 Typical High $0.41 | Professional | 78 · Unplanned return to OR | $0.35 | $0.40 | $0.41 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.15 Median $0.36 Typical High $0.36 | Professional | 52 · Reduced service | $0.15 | $0.36 | $0.36 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.06 Median $0.14 Typical High $0.14 | Professional | 53 · Discontinued | $0.06 | $0.14 | $0.14 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.04 Median $0.11 Typical High $0.11 | Professional | 55 · Aftercare only | $0.04 | $0.11 | $0.11 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.07 Typical High $0.07 | Professional | 56 · Pre-op care only | $0.03 | $0.07 | $0.07 |
Where Idaho sits
The same service costs 4.6 times more in Hawaii than in Rhode Island. 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· 9th of 51
$0.56
HI $1.05RI $0.23
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.