How much rates vary
Facilitymedian $6 · 10th to 90th $4 to $11Professionalmedian $7 · 10th to 90th $3 to $9
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 $3.80 Median $9.12 Typical High $9.12 | Professional | None | $3.80 | $9.12 | $9.12 |
BCBS Idaho Setting Facility Modifier None Typical Low $4.79 Median $6.31 Typical High $10.72 | Facility | None | $4.79 | $6.31 | $10.72 |
BCBS Idaho Setting Professional Modifier None Typical Low $4.79 Median $7.08 Typical High $7.41 | Professional | None | $4.79 | $7.08 | $7.41 |
Cigna Setting Facility Modifier None Typical Low $3.98 Median $3.98 Typical High $4.27 | Facility | None | $3.98 | $3.98 | $4.27 |
Cigna Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.98 | Professional | None | $3.39 | $3.39 | $3.98 |
Moda Health Setting Facility Modifier None Typical Low $1.82 Median $6.46 Typical High $9.12 | Facility | None | $1.82 | $6.46 | $9.12 |
Moda Health Setting Professional Modifier None Typical Low $4.90 Median $7.08 Typical High $9.12 | Professional | None | $4.90 | $7.08 | $9.12 |
Molina Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $30.20 | Professional | None | $4.68 | $4.68 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $5.37 Median $8.51 Typical High $407.38 | Facility | None | $5.37 | $8.51 | $407.38 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $6.76 Median $8.51 Typical High $478.63 | Professional | None | $6.76 | $8.51 | $478.63 |
Regence BlueShield Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $7.08 | Professional | None | $4.79 | $4.79 | $7.08 |
Select Health Setting Facility Modifier None Typical Low $6.76 Median $6.76 Typical High $8.71 | Facility | None | $6.76 | $6.76 | $8.71 |
Select Health Setting Professional Modifier None Typical Low $4.37 Median $6.76 Typical High $7.41 | Professional | None | $4.37 | $6.76 | $7.41 |
United Setting Professional Modifier None Typical Low $2.57 Median $2.82 Typical High $4.27 | Professional | None | $2.57 | $2.82 | $4.27 |
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 $1.91 Median $4.47 Typical High $4.47 | Professional | 52 · Reduced service | $1.91 | $4.47 | $4.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.76 Median $1.82 Typical High $1.82 | Professional | 53 · Discontinued | $0.76 | $1.82 | $1.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.56 Median $1.35 Typical High $1.35 | Professional | 55 · Aftercare only | $0.56 | $1.35 | $1.35 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.38 Median $0.89 Typical High $0.89 | Professional | 56 · Pre-op care only | $0.38 | $0.89 | $0.89 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $4.47 Median $5.01 Typical High $5.25 | Professional | 78 · Unplanned return to OR | $4.47 | $5.01 | $5.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.91 Median $4.47 Typical High $4.47 | Professional | 52 · Reduced service | $1.91 | $4.47 | $4.47 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.76 Median $1.82 Typical High $1.82 | Professional | 53 · Discontinued | $0.76 | $1.82 | $1.82 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.58 Median $1.35 Typical High $1.35 | Professional | 55 · Aftercare only | $0.58 | $1.35 | $1.35 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.38 Median $0.89 Typical High $0.89 | Professional | 56 · Pre-op care only | $0.38 | $0.89 | $0.89 |
Where Idaho sits
The same service costs 2.1 times more in Kansas than in Alabama. 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
$7.08
KS $7.08AL $3.39
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.