How much rates vary
Facilitymedian $4 · 10th to 90th $3 to $141Professionalmedian $4 · 10th to 90th $2 to $5
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 $1.86 Median $5.01 Typical High $5.01 | Professional | None | $1.86 | $5.01 | $5.01 |
Aetna Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | AU · Urologic/ostomy supply | $1.20 | $1.20 | $1.20 |
BCBS Idaho Setting Facility Modifier None Typical Low $2.88 Median $3.63 Typical High $6.17 | Facility | None | $2.88 | $3.63 | $6.17 |
BCBS Idaho Setting Professional Modifier None Typical Low $2.63 Median $3.98 Typical High $4.17 | Professional | None | $2.63 | $3.98 | $4.17 |
BCBS Idaho Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $2.63 Median $3.98 Typical High $4.17 | Professional | AU · Urologic/ostomy supply | $2.63 | $3.98 | $4.17 |
Cigna Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | None | $2.24 | $2.24 | $2.24 |
Moda Health Setting Facility Modifier None Typical Low $2.45 Median $5.01 Typical High $7.24 | Facility | None | $2.45 | $5.01 | $7.24 |
Moda Health Setting Professional Modifier None Typical Low $2.45 Median $3.98 Typical High $5.01 | Professional | None | $2.45 | $3.98 | $5.01 |
Moda Health Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $1.20 Median $1.20 Typical High $3.98 | Professional | AU · Urologic/ostomy supply | $1.20 | $1.20 | $3.98 |
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 $4.79 Median $141.25 Typical High $229.09 | Facility | None | $4.79 | $141.25 | $229.09 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $3.98 Median $4.79 Typical High $269.15 | Professional | None | $3.98 | $4.79 | $269.15 |
MountainHealth Co-op Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | AU · Urologic/ostomy supply | $3.98 | $3.98 | $3.98 |
Regence BlueShield Setting Professional Modifier None Typical Low $2.63 Median $2.63 Typical High $3.98 | Professional | None | $2.63 | $2.63 | $3.98 |
Regence BlueShield Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $2.63 Median $2.63 Typical High $3.98 | Professional | AU · Urologic/ostomy supply | $2.63 | $2.63 | $3.98 |
Select Health Setting Facility Modifier None Typical Low $3.80 Median $3.80 Typical High $4.90 | Facility | None | $3.80 | $3.80 | $4.90 |
Select Health Setting Professional Modifier None Typical Low $3.80 Median $4.17 Typical High $8.91 | Professional | None | $3.80 | $4.17 | $8.91 |
United Setting Professional Modifier None Typical Low $1.45 Median $1.86 Typical High $2.69 | Professional | None | $1.45 | $1.86 | $2.69 |
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 $1.23 Median $2.51 Typical High $2.51 | Professional | 52 · Reduced service | $1.23 | $2.51 | $2.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.50 Median $1.00 Typical High $1.00 | Professional | 53 · Discontinued | $0.50 | $1.00 | $1.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.37 Median $0.76 Typical High $0.76 | Professional | 55 · Aftercare only | $0.37 | $0.76 | $0.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.25 Median $0.51 Typical High $0.51 | Professional | 56 · Pre-op care only | $0.25 | $0.51 | $0.51 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2.51 Median $2.82 Typical High $2.95 | Professional | 78 · Unplanned return to OR | $2.51 | $2.82 | $2.95 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.23 Median $2.51 Typical High $2.51 | Professional | 52 · Reduced service | $1.23 | $2.51 | $2.51 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.50 Median $1.00 Typical High $1.00 | Professional | 53 · Discontinued | $0.50 | $1.00 | $1.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.37 Median $0.76 Typical High $0.76 | Professional | 55 · Aftercare only | $0.37 | $0.76 | $0.76 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.25 Median $0.51 Typical High $0.51 | Professional | 56 · Pre-op care only | $0.25 | $0.51 | $0.51 |
Where Idaho sits
The same service costs 4.4 times more in Minnesota than in New Hampshire. 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· 2nd of 51
$3.98
MN $5.25NH $1.20
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.