How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $4.37 Median $4.47 Typical High $4.47 | Professional | None | $4.37 | $4.47 | $4.47 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.19 Median $2.24 Typical High $2.24 | Professional | 52 · Reduced service | $2.19 | $2.24 | $2.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.87 Median $0.89 Typical High $0.89 | Professional | 53 · Discontinued | $0.87 | $0.89 | $0.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.66 Median $0.66 Typical High $0.66 | Professional | 55 · Aftercare only | $0.66 | $0.66 | $0.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.44 Median $0.44 Typical High $0.44 | Professional | 56 · Pre-op care only | $0.44 | $0.44 | $0.44 |
BCBS Idaho Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $44.67 | Facility | None | $43.65 | $43.65 | $44.67 |
BCBS Idaho Setting Professional Modifier None Typical Low $19.05 Median $28.84 Typical High $30.20 | Professional | None | $19.05 | $28.84 | $30.20 |
Cigna Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | None | $13.49 | $13.49 | $13.49 |
Moda Health Setting Facility Modifier None Typical Low $4.37 Median $6.31 Typical High $25.70 | Facility | None | $4.37 | $6.31 | $25.70 |
Moda Health Setting Professional Modifier None Typical Low $4.37 Median $4.47 Typical High $28.84 | Professional | None | $4.37 | $4.47 | $28.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2.19 Median $2.24 Typical High $2.24 | Professional | 52 · Reduced service | $2.19 | $2.24 | $2.24 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.87 Median $0.89 Typical High $0.89 | Professional | 53 · Discontinued | $0.87 | $0.89 | $0.89 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.66 Median $0.66 Typical High $0.66 | Professional | 55 · Aftercare only | $0.66 | $0.66 | $0.66 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.44 Median $0.44 Typical High $0.44 | Professional | 56 · Pre-op care only | $0.44 | $0.44 | $0.44 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $33.88 Median $1,000.00 Typical High $1,621.81 | Facility | None | $33.88 | $1,000.00 | $1,621.81 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $28.84 Median $33.88 Typical High $1,905.46 | Professional | None | $28.84 | $33.88 | $1,905.46 |
Regence BlueShield Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $28.84 | Professional | None | $19.05 | $19.05 | $28.84 |
Select Health Setting Facility Modifier None Typical Low $23.44 Median $27.54 Typical High $28.18 | Facility | None | $23.44 | $27.54 | $28.18 |
Select Health Setting Professional Modifier None Typical Low $27.54 Median $28.84 Typical High $63.10 | Professional | None | $27.54 | $28.84 | $63.10 |
United Setting Professional Modifier None Typical Low $8.91 Median $12.02 Typical High $14.13 | Professional | None | $8.91 | $12.02 | $14.13 |
1 more rate 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 |
|---|---|---|---|---|---|
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $17.78 Median $19.95 Typical High $20.89 | Professional | 78 · Unplanned return to OR | $17.78 | $19.95 | $20.89 |
Where Idaho sits
The same service costs 6.9 times more in Montana than in Indiana. 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· 12th of 51
$19.05
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.