How much rates vary
Facilitymedian $5 · 10th to 90th $3 to $10Professionalmedian $6 · 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 $2.95 Median $7.08 Typical High $7.08 | Professional | None | $2.95 | $7.08 | $7.08 |
BCBS Idaho Setting Facility Modifier None Typical Low $3.80 Median $5.13 Typical High $8.51 | Facility | None | $3.80 | $5.13 | $8.51 |
BCBS Idaho Setting Professional Modifier None Typical Low $3.72 Median $5.62 Typical High $5.89 | Professional | None | $3.72 | $5.62 | $5.89 |
Cigna Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $3.72 | Facility | None | $3.55 | $3.55 | $3.72 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $3.55 | Professional | None | $2.95 | $2.95 | $3.55 |
Moda Health Setting Facility Modifier None Typical Low $1.45 Median $5.13 Typical High $7.08 | Facility | None | $1.45 | $5.13 | $7.08 |
Moda Health Setting Professional Modifier None Typical Low $3.89 Median $5.62 Typical High $7.08 | Professional | None | $3.89 | $5.62 | $7.08 |
Molina Setting Professional Modifier None Typical Low $3.72 Median $5.62 Typical High $30.20 | Professional | None | $3.72 | $5.62 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $4.27 Median $6.76 Typical High $323.59 | Facility | None | $4.27 | $6.76 | $323.59 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $5.62 Median $6.76 Typical High $380.19 | Professional | None | $5.62 | $6.76 | $380.19 |
Regence BlueShield Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $5.62 | Professional | None | $3.72 | $3.72 | $5.62 |
Select Health Setting Facility Modifier None Typical Low $5.37 Median $5.37 Typical High $6.92 | Facility | None | $5.37 | $5.37 | $6.92 |
Select Health Setting Professional Modifier None Typical Low $3.47 Median $5.37 Typical High $5.89 | Professional | None | $3.47 | $5.37 | $5.89 |
United Setting Professional Modifier None Typical Low $2.04 Median $2.24 Typical High $3.72 | Professional | None | $2.04 | $2.24 | $3.72 |
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 $1.48 Median $3.55 Typical High $3.55 | Professional | 52 · Reduced service | $1.48 | $3.55 | $3.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.60 Median $1.45 Typical High $1.45 | Professional | 53 · Discontinued | $0.60 | $1.45 | $1.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.45 Median $1.07 Typical High $1.07 | Professional | 55 · Aftercare only | $0.45 | $1.07 | $1.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.71 Typical High $0.71 | Professional | 56 · Pre-op care only | $0.30 | $0.71 | $0.71 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3.55 Median $3.98 Typical High $4.17 | Professional | 78 · Unplanned return to OR | $3.55 | $3.98 | $4.17 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.48 Median $3.55 Typical High $3.55 | Professional | 52 · Reduced service | $1.48 | $3.55 | $3.55 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.60 Median $1.45 Typical High $1.45 | Professional | 53 · Discontinued | $0.60 | $1.45 | $1.45 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.45 Median $1.07 Typical High $1.07 | Professional | 55 · Aftercare only | $0.45 | $1.07 | $1.07 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.71 Typical High $0.71 | Professional | 56 · Pre-op care only | $0.30 | $0.71 | $0.71 |
Where Idaho sits
The same service costs 2.6 times more in Kansas than in New Hampshire. 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
$5.62
KS $6.76NH $2.63
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.