How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $1.95 Median $4.68 Typical High $4.68 | Professional | None | $1.95 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.98 Median $2.34 Typical High $2.34 | Professional | 52 · Reduced service | $0.98 | $2.34 | $2.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.39 Median $0.93 Typical High $0.93 | Professional | 53 · Discontinued | $0.39 | $0.93 | $0.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.28 Median $0.71 Typical High $0.71 | Professional | 55 · Aftercare only | $0.28 | $0.71 | $0.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.19 Median $0.47 Typical High $0.47 | Professional | 56 · Pre-op care only | $0.19 | $0.47 | $0.47 |
BCBS Idaho Setting Facility Modifier None Typical Low $3.24 Median $4.79 Typical High $5.89 | Facility | None | $3.24 | $4.79 | $5.89 |
BCBS Idaho Setting Professional Modifier None Typical Low $2.45 Median $3.80 Typical High $3.98 | Professional | None | $2.45 | $3.80 | $3.98 |
Cigna Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | None | $2.00 | $2.00 | $2.00 |
Moda Health Setting Facility Modifier None Typical Low $1.95 Median $3.31 Typical High $4.68 | Facility | None | $1.95 | $3.31 | $4.68 |
Moda Health Setting Professional Modifier None Typical Low $1.95 Median $3.63 Typical High $4.68 | Professional | None | $1.95 | $3.63 | $4.68 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.98 Median $2.34 Typical High $2.34 | Professional | 52 · Reduced service | $0.98 | $2.34 | $2.34 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.39 Median $0.93 Typical High $0.93 | Professional | 53 · Discontinued | $0.39 | $0.93 | $0.93 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.29 Median $0.71 Typical High $0.71 | Professional | 55 · Aftercare only | $0.29 | $0.71 | $0.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.19 Median $0.47 Typical High $0.47 | Professional | 56 · Pre-op care only | $0.19 | $0.47 | $0.47 |
Molina Setting Professional Modifier None Typical Low $2.57 Median $3.02 Typical High $3.02 | Professional | None | $2.57 | $3.02 | $3.02 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $4.37 Median $128.82 Typical High $208.93 | Facility | None | $4.37 | $128.82 | $208.93 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $3.63 Median $4.37 Typical High $245.47 | Professional | None | $3.63 | $4.37 | $245.47 |
Regence BlueShield Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $3.63 | Professional | None | $2.45 | $2.45 | $3.63 |
Select Health Setting Facility Modifier None Typical Low $3.47 Median $3.47 Typical High $3.55 | Facility | None | $3.47 | $3.47 | $3.55 |
Select Health Setting Professional Modifier None Typical Low $3.47 Median $3.80 Typical High $7.94 | Professional | None | $3.47 | $3.80 | $7.94 |
United Setting Professional Modifier None Typical Low $1.32 Median $1.70 Typical High $1.95 | Professional | None | $1.32 | $1.70 | $1.95 |
1 more rate 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 $2.34 Median $2.63 Typical High $2.75 | Professional | 78 · Unplanned return to OR | $2.34 | $2.63 | $2.75 |
Where Idaho sits
The same service costs 2.3 times more in Hawaii 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· 3rd of 51
$3.63
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.