How much rates vary
Facilitymedian $2 · 10th to 90th $1 to $3Professionalmedian $2 · 10th to 90th $1 to $2
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 $1.02 Median $2.45 Typical High $2.45 | Professional | None | $1.02 | $2.45 | $2.45 |
BCBS Idaho Setting Facility Modifier None Typical Low $1.20 Median $1.74 Typical High $2.95 | Facility | None | $1.20 | $1.74 | $2.95 |
BCBS Idaho Setting Professional Modifier None Typical Low $1.29 Median $1.95 Typical High $2.04 | Professional | None | $1.29 | $1.95 | $2.04 |
Cigna Setting Facility Modifier None Typical Low $1.10 Median $1.10 Typical High $1.15 | Facility | None | $1.10 | $1.10 | $1.15 |
Cigna Setting Professional Modifier None Typical Low $0.93 Median $0.93 Typical High $1.10 | Professional | None | $0.93 | $0.93 | $1.10 |
Moda Health Setting Facility Modifier None Typical Low $0.50 Median $1.74 Typical High $2.45 | Facility | None | $0.50 | $1.74 | $2.45 |
Moda Health Setting Professional Modifier None Typical Low $1.32 Median $1.95 Typical High $2.45 | Professional | None | $1.32 | $1.95 | $2.45 |
Molina Setting Professional Modifier None Typical Low $1.29 Median $1.95 Typical High $30.20 | Professional | None | $1.29 | $1.95 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $1.45 Median $2.29 Typical High $109.65 | Facility | None | $1.45 | $2.29 | $109.65 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1.95 Median $2.29 Typical High $128.82 | Professional | None | $1.95 | $2.29 | $128.82 |
Regence BlueShield Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.95 | Professional | None | $1.29 | $1.29 | $1.95 |
Select Health Setting Facility Modifier None Typical Low $1.82 Median $1.82 Typical High $2.40 | Facility | None | $1.82 | $1.82 | $2.40 |
Select Health Setting Professional Modifier None Typical Low $1.20 Median $1.82 Typical High $2.00 | Professional | None | $1.20 | $1.82 | $2.00 |
United Setting Professional Modifier None Typical Low $0.71 Median $0.78 Typical High $1.07 | Professional | None | $0.71 | $0.78 | $1.07 |
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 $0.51 Median $1.23 Typical High $1.23 | Professional | 52 · Reduced service | $0.51 | $1.23 | $1.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.20 Median $0.49 Typical High $0.49 | Professional | 53 · Discontinued | $0.20 | $0.49 | $0.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.15 Median $0.37 Typical High $0.37 | Professional | 55 · Aftercare only | $0.15 | $0.37 | $0.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.25 Typical High $0.25 | Professional | 56 · Pre-op care only | $0.10 | $0.25 | $0.25 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1.20 Median $1.35 Typical High $1.41 | Professional | 78 · Unplanned return to OR | $1.20 | $1.35 | $1.41 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.51 Median $1.23 Typical High $1.23 | Professional | 52 · Reduced service | $0.51 | $1.23 | $1.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.20 Median $0.49 Typical High $0.49 | Professional | 53 · Discontinued | $0.20 | $0.49 | $0.49 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.15 Median $0.37 Typical High $0.37 | Professional | 55 · Aftercare only | $0.15 | $0.37 | $0.37 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.25 Typical High $0.25 | Professional | 56 · Pre-op care only | $0.10 | $0.25 | $0.25 |
Where Idaho sits
The same service costs 2.1 times more in Hawaii than in New Jersey. 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
$1.91
HI $1.95NJ $0.93
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.