How much rates vary
Facilitymedian $5 · 10th to 90th $3 to $8Professionalmedian $5 · 10th to 90th $2 to $7
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 $2.82 Median $6.76 Typical High $6.76 | Professional | None | $2.82 | $6.76 | $6.76 |
BCBS Idaho Setting Facility Modifier None Typical Low $3.16 Median $4.79 Typical High $8.32 | Facility | None | $3.16 | $4.79 | $8.32 |
BCBS Idaho Setting Professional Modifier None Typical Low $3.55 Median $5.37 Typical High $5.62 | Professional | None | $3.55 | $5.37 | $5.62 |
Cigna Setting Facility Modifier None Typical Low $3.02 Median $3.02 Typical High $3.24 | Facility | None | $3.02 | $3.02 | $3.24 |
Cigna Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $3.02 | Professional | None | $2.57 | $2.57 | $3.02 |
Moda Health Setting Facility Modifier None Typical Low $1.38 Median $4.90 Typical High $6.76 | Facility | None | $1.38 | $4.90 | $6.76 |
Moda Health Setting Professional Modifier None Typical Low $3.63 Median $5.37 Typical High $6.76 | Professional | None | $3.63 | $5.37 | $6.76 |
Molina Setting Professional Modifier None Typical Low $3.55 Median $5.37 Typical High $30.20 | Professional | None | $3.55 | $5.37 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $4.07 Median $6.31 Typical High $309.03 | Facility | None | $4.07 | $6.31 | $309.03 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $5.13 Median $6.31 Typical High $363.08 | Professional | None | $5.13 | $6.31 | $363.08 |
Regence BlueShield Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $5.37 | Professional | None | $3.55 | $3.55 | $5.37 |
Select Health Setting Facility Modifier None Typical Low $5.13 Median $5.13 Typical High $6.61 | Facility | None | $5.13 | $5.13 | $6.61 |
Select Health Setting Professional Modifier None Typical Low $3.31 Median $5.13 Typical High $5.62 | Professional | None | $3.31 | $5.13 | $5.62 |
United Setting Professional Modifier None Typical Low $1.95 Median $2.14 Typical High $3.24 | Professional | None | $1.95 | $2.14 | $3.24 |
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 $1.41 Median $3.39 Typical High $3.39 | Professional | 52 · Reduced service | $1.41 | $3.39 | $3.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.56 Median $1.35 Typical High $1.35 | Professional | 53 · Discontinued | $0.56 | $1.35 | $1.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.43 Median $1.02 Typical High $1.02 | Professional | 55 · Aftercare only | $0.43 | $1.02 | $1.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.68 Typical High $0.68 | Professional | 56 · Pre-op care only | $0.28 | $0.68 | $0.68 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3.31 Median $3.72 Typical High $3.89 | Professional | 78 · Unplanned return to OR | $3.31 | $3.72 | $3.89 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.41 Median $3.39 Typical High $3.39 | Professional | 52 · Reduced service | $1.41 | $3.39 | $3.39 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.58 Median $1.35 Typical High $1.35 | Professional | 53 · Discontinued | $0.58 | $1.35 | $1.35 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.43 Median $1.02 Typical High $1.02 | Professional | 55 · Aftercare only | $0.43 | $1.02 | $1.02 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.68 Typical High $0.68 | Professional | 56 · Pre-op care only | $0.28 | $0.68 | $0.68 |
Where Idaho sits
The same service costs 2.3 times more in Kansas than in Connecticut. 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
$5.37
KS $6.03CT $2.57
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.