How much rates vary
Facilitymedian $9 · 10th to 90th $5 to $15Professionalmedian $10 · 10th to 90th $4 to $12
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 $5.13 Median $12.30 Typical High $12.30 | Professional | None | $5.13 | $12.30 | $12.30 |
BCBS Idaho Setting Facility Modifier None Typical Low $5.75 Median $8.71 Typical High $14.79 | Facility | None | $5.75 | $8.71 | $14.79 |
BCBS Idaho Setting Professional Modifier None Typical Low $6.46 Median $9.77 Typical High $10.23 | Professional | None | $6.46 | $9.77 | $10.23 |
Cigna Setting Facility Modifier None Typical Low $5.50 Median $5.50 Typical High $5.89 | Facility | None | $5.50 | $5.50 | $5.89 |
Cigna Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $5.50 | Professional | None | $4.68 | $4.68 | $5.50 |
Moda Health Setting Facility Modifier None Typical Low $2.51 Median $8.91 Typical High $12.30 | Facility | None | $2.51 | $8.91 | $12.30 |
Moda Health Setting Professional Modifier None Typical Low $6.61 Median $9.77 Typical High $12.30 | Professional | None | $6.61 | $9.77 | $12.30 |
Molina Setting Professional Modifier None Typical Low $6.46 Median $9.77 Typical High $30.20 | Professional | None | $6.46 | $9.77 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $7.41 Median $11.48 Typical High $562.34 | Facility | None | $7.41 | $11.48 | $562.34 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $9.33 Median $11.48 Typical High $660.69 | Professional | None | $9.33 | $11.48 | $660.69 |
Regence BlueShield Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $9.77 | Professional | None | $6.46 | $6.46 | $9.77 |
Select Health Setting Facility Modifier None Typical Low $9.33 Median $9.33 Typical High $12.02 | Facility | None | $9.33 | $9.33 | $12.02 |
Select Health Setting Professional Modifier None Typical Low $6.03 Median $9.33 Typical High $10.23 | Professional | None | $6.03 | $9.33 | $10.23 |
United Setting Professional Modifier None Typical Low $3.55 Median $3.89 Typical High $5.89 | Professional | None | $3.55 | $3.89 | $5.89 |
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 $2.57 Median $6.17 Typical High $6.17 | Professional | 52 · Reduced service | $2.57 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.02 Median $2.45 Typical High $2.45 | Professional | 53 · Discontinued | $1.02 | $2.45 | $2.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.78 Median $1.86 Typical High $1.86 | Professional | 55 · Aftercare only | $0.78 | $1.86 | $1.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $1.23 Typical High $1.23 | Professional | 56 · Pre-op care only | $0.52 | $1.23 | $1.23 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $6.03 Median $6.76 Typical High $7.08 | Professional | 78 · Unplanned return to OR | $6.03 | $6.76 | $7.08 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2.57 Median $6.17 Typical High $6.17 | Professional | 52 · Reduced service | $2.57 | $6.17 | $6.17 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.02 Median $2.45 Typical High $2.45 | Professional | 53 · Discontinued | $1.02 | $2.45 | $2.45 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.78 Median $1.86 Typical High $1.86 | Professional | 55 · Aftercare only | $0.78 | $1.86 | $1.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $1.23 Typical High $1.23 | Professional | 56 · Pre-op care only | $0.52 | $1.23 | $1.23 |
Where Idaho sits
The same service costs 2.3 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· 2nd of 51
$9.77
KS $10.72AL $4.68
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.