How much rates vary
Facilitymedian $6 · 10th to 90th $4 to $13Professionalmedian $7 · 10th to 90th $3 to $9
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 $3.72 Median $8.91 Typical High $8.91 | Professional | None | $3.72 | $8.91 | $8.91 |
BCBS Idaho Setting Facility Modifier None Typical Low $3.89 Median $5.89 Typical High $10.47 | Facility | None | $3.89 | $5.89 | $10.47 |
BCBS Idaho Setting Professional Modifier None Typical Low $4.68 Median $6.92 Typical High $7.41 | Professional | None | $4.68 | $6.92 | $7.41 |
Cigna Setting Facility Modifier None Typical Low $3.89 Median $3.89 Typical High $4.17 | Facility | None | $3.89 | $3.89 | $4.17 |
Cigna Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $3.89 | Professional | None | $3.31 | $3.31 | $3.89 |
Moda Health Setting Facility Modifier None Typical Low $4.07 Median $6.31 Typical High $8.91 | Facility | None | $4.07 | $6.31 | $8.91 |
Moda Health Setting Professional Modifier None Typical Low $4.07 Median $6.92 Typical High $8.91 | Professional | None | $4.07 | $6.92 | $8.91 |
Molina Setting Professional Modifier None Typical Low $4.57 Median $4.57 Typical High $30.20 | Professional | None | $4.57 | $4.57 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $5.25 Median $8.32 Typical High $398.11 | Facility | None | $5.25 | $8.32 | $398.11 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $6.61 Median $8.32 Typical High $467.74 | Professional | None | $6.61 | $8.32 | $467.74 |
Regence BlueShield Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $6.92 | Professional | None | $4.68 | $4.68 | $6.92 |
Select Health Setting Facility Modifier None Typical Low $6.61 Median $6.61 Typical High $6.76 | Facility | None | $6.61 | $6.61 | $6.76 |
Select Health Setting Professional Modifier None Typical Low $4.37 Median $6.61 Typical High $7.24 | Professional | None | $4.37 | $6.61 | $7.24 |
United Setting Professional Modifier None Typical Low $2.51 Median $2.75 Typical High $4.79 | Professional | None | $2.51 | $2.75 | $4.79 |
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 $1.86 Median $4.47 Typical High $4.47 | Professional | 52 · Reduced service | $1.86 | $4.47 | $4.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.74 Median $1.78 Typical High $1.78 | Professional | 53 · Discontinued | $0.74 | $1.78 | $1.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.56 Median $1.32 Typical High $1.32 | Professional | 55 · Aftercare only | $0.56 | $1.32 | $1.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.37 Median $0.89 Typical High $0.89 | Professional | 56 · Pre-op care only | $0.37 | $0.89 | $0.89 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $4.37 Median $4.90 Typical High $5.13 | Professional | 78 · Unplanned return to OR | $4.37 | $4.90 | $5.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.86 Median $4.47 Typical High $4.47 | Professional | 52 · Reduced service | $1.86 | $4.47 | $4.47 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.74 Median $1.78 Typical High $1.78 | Professional | 53 · Discontinued | $0.74 | $1.78 | $1.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.56 Median $1.32 Typical High $1.32 | Professional | 55 · Aftercare only | $0.56 | $1.32 | $1.32 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.37 Median $0.89 Typical High $0.89 | Professional | 56 · Pre-op care only | $0.37 | $0.89 | $0.89 |
Where Idaho sits
The same service costs 2.1 times more in Montana than in New Jersey. 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
$6.92
MT $6.92NJ $3.31
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.