How much rates vary
Facilitymedian $3 · 10th to 90th $2 to $4Professionalmedian $3 · 10th to 90th $1 to $4
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 $1.48 Median $3.55 Typical High $3.55 | Professional | None | $1.48 | $3.55 | $3.55 |
BCBS Idaho Setting Facility Modifier None Typical Low $1.91 Median $2.51 Typical High $4.17 | Facility | None | $1.91 | $2.51 | $4.17 |
BCBS Idaho Setting Professional Modifier None Typical Low $1.86 Median $2.75 Typical High $2.88 | Professional | None | $1.86 | $2.75 | $2.88 |
Cigna Setting Facility Modifier None Typical Low $1.55 Median $1.55 Typical High $1.66 | Facility | None | $1.55 | $1.55 | $1.66 |
Cigna Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.55 | Professional | None | $1.32 | $1.32 | $1.55 |
Moda Health Setting Facility Modifier None Typical Low $0.71 Median $2.51 Typical High $3.55 | Facility | None | $0.71 | $2.51 | $3.55 |
Moda Health Setting Professional Modifier None Typical Low $1.91 Median $2.75 Typical High $3.55 | Professional | None | $1.91 | $2.75 | $3.55 |
Molina Setting Professional Modifier None Typical Low $1.82 Median $1.82 Typical High $30.20 | Professional | None | $1.82 | $1.82 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $2.09 Median $3.31 Typical High $158.49 | Facility | None | $2.09 | $3.31 | $158.49 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2.75 Median $3.31 Typical High $186.21 | Professional | None | $2.75 | $3.31 | $186.21 |
Regence BlueShield Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $2.75 | Professional | None | $1.86 | $1.86 | $2.75 |
Select Health Setting Facility Modifier None Typical Low $2.63 Median $2.63 Typical High $3.39 | Facility | None | $2.63 | $2.63 | $3.39 |
Select Health Setting Professional Modifier None Typical Low $1.74 Median $2.63 Typical High $2.88 | Professional | None | $1.74 | $2.63 | $2.88 |
United Setting Professional Modifier None Typical Low $1.00 Median $1.10 Typical High $1.62 | Professional | None | $1.00 | $1.10 | $1.62 |
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 $0.74 Median $1.78 Typical High $1.78 | Professional | 52 · Reduced service | $0.74 | $1.78 | $1.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.28 Median $0.71 Typical High $0.71 | Professional | 53 · Discontinued | $0.28 | $0.71 | $0.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.22 Median $0.52 Typical High $0.52 | Professional | 55 · Aftercare only | $0.22 | $0.52 | $0.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.15 Median $0.35 Typical High $0.35 | Professional | 56 · Pre-op care only | $0.15 | $0.35 | $0.35 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1.74 Median $1.95 Typical High $2.04 | Professional | 78 · Unplanned return to OR | $1.74 | $1.95 | $2.04 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.74 Median $1.78 Typical High $1.78 | Professional | 52 · Reduced service | $0.74 | $1.78 | $1.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.29 Median $0.71 Typical High $0.71 | Professional | 53 · Discontinued | $0.29 | $0.71 | $0.71 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.22 Median $0.52 Typical High $0.52 | Professional | 55 · Aftercare only | $0.22 | $0.52 | $0.52 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.15 Median $0.35 Typical High $0.35 | Professional | 56 · Pre-op care only | $0.15 | $0.35 | $0.35 |
Where Idaho sits
The same service costs 2.3 times more in Kansas 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
$2.75
KS $3.09NJ $1.32
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.