How much rates vary
Facilitymedian $4 · 10th to 90th $3 to $6Professionalmedian $4 · 10th to 90th $2 to $5
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 $2.51 Median $5.13 Typical High $5.13 | Professional | None | $2.51 | $5.13 | $5.13 |
BCBS Idaho Setting Facility Modifier None Typical Low $2.75 Median $3.63 Typical High $6.17 | Facility | None | $2.75 | $3.63 | $6.17 |
BCBS Idaho Setting Professional Modifier None Typical Low $2.69 Median $4.07 Typical High $4.27 | Professional | None | $2.69 | $4.07 | $4.27 |
Cigna Setting Facility Modifier None Typical Low $2.69 Median $2.69 Typical High $2.82 | Facility | None | $2.69 | $2.69 | $2.82 |
Cigna Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $2.69 | Professional | None | $2.29 | $2.29 | $2.69 |
Moda Health Setting Facility Modifier None Typical Low $1.23 Median $3.63 Typical High $5.13 | Facility | None | $1.23 | $3.63 | $5.13 |
Moda Health Setting Professional Modifier None Typical Low $2.75 Median $4.07 Typical High $5.13 | Professional | None | $2.75 | $4.07 | $5.13 |
Molina Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $30.20 | Professional | None | $2.69 | $2.69 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $3.09 Median $4.79 Typical High $229.09 | Facility | None | $3.09 | $4.79 | $229.09 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $3.89 Median $4.79 Typical High $269.15 | Professional | None | $3.89 | $4.79 | $269.15 |
Regence BlueShield Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $4.07 | Professional | None | $2.69 | $2.69 | $4.07 |
Select Health Setting Facility Modifier None Typical Low $3.89 Median $3.89 Typical High $5.01 | Facility | None | $3.89 | $3.89 | $5.01 |
Select Health Setting Professional Modifier None Typical Low $2.51 Median $3.89 Typical High $4.27 | Professional | None | $2.51 | $3.89 | $4.27 |
United Setting Professional Modifier None Typical Low $1.74 Median $1.91 Typical High $2.95 | Professional | None | $1.74 | $1.91 | $2.95 |
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 $1.26 Median $2.57 Typical High $2.57 | Professional | 52 · Reduced service | $1.26 | $2.57 | $2.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.50 Median $1.02 Typical High $1.02 | Professional | 53 · Discontinued | $0.50 | $1.02 | $1.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.38 Median $0.78 Typical High $0.78 | Professional | 55 · Aftercare only | $0.38 | $0.78 | $0.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.25 Median $0.52 Typical High $0.52 | Professional | 56 · Pre-op care only | $0.25 | $0.52 | $0.52 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2.51 Median $2.82 Typical High $2.95 | Professional | 78 · Unplanned return to OR | $2.51 | $2.82 | $2.95 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.26 Median $2.57 Typical High $2.57 | Professional | 52 · Reduced service | $1.26 | $2.57 | $2.57 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.50 Median $1.02 Typical High $1.02 | Professional | 53 · Discontinued | $0.50 | $1.02 | $1.02 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.38 Median $0.78 Typical High $0.78 | Professional | 55 · Aftercare only | $0.38 | $0.78 | $0.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.25 Median $0.52 Typical High $0.52 | Professional | 56 · Pre-op care only | $0.25 | $0.52 | $0.52 |
Where Idaho sits
The same service costs 2.1 times more in Montana 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
$4.07
MT $4.68NH $2.24
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.