How much rates vary
Facilitymedian $1 · 10th to 90th $0 to $17Professionalmedian $0 · 10th to 90th $0 to $1
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 $0.25 Median $0.60 Typical High $0.60 | Professional | None | $0.25 | $0.60 | $0.60 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.13 Median $0.30 Typical High $0.30 | Professional | 52 · Reduced service | $0.13 | $0.30 | $0.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.05 Median $0.12 Typical High $0.12 | Professional | 53 · Discontinued | $0.05 | $0.12 | $0.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.04 Median $0.09 Typical High $0.09 | Professional | 55 · Aftercare only | $0.04 | $0.09 | $0.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.06 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.03 | $0.06 | $0.06 |
BCBS Idaho Setting Facility Modifier None Typical Low $0.33 Median $0.44 Typical High $1.02 | Facility | None | $0.33 | $0.44 | $1.02 |
BCBS Idaho Setting Professional Modifier None Typical Low $0.32 Median $0.47 Typical High $0.50 | Professional | None | $0.32 | $0.47 | $0.50 |
Cigna Setting Professional Modifier None Typical Low $0.22 Median $0.22 Typical High $0.22 | Professional | None | $0.22 | $0.22 | $0.22 |
Moda Health Setting Facility Modifier None Typical Low $0.40 Median $0.43 Typical High $0.60 | Facility | None | $0.40 | $0.43 | $0.60 |
Moda Health Setting Professional Modifier None Typical Low $0.25 Median $0.47 Typical High $0.60 | Professional | None | $0.25 | $0.47 | $0.60 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.13 Median $0.30 Typical High $0.30 | Professional | 52 · Reduced service | $0.13 | $0.30 | $0.30 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.05 Median $0.12 Typical High $0.12 | Professional | 53 · Discontinued | $0.05 | $0.12 | $0.12 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.04 Median $0.09 Typical High $0.09 | Professional | 55 · Aftercare only | $0.04 | $0.09 | $0.09 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.06 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.03 | $0.06 | $0.06 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $0.56 Median $16.60 Typical High $26.92 | Facility | None | $0.56 | $16.60 | $26.92 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $0.47 Median $0.56 Typical High $31.62 | Professional | None | $0.47 | $0.56 | $31.62 |
Regence BlueShield Setting Professional Modifier None Typical Low $0.32 Median $0.32 Typical High $0.47 | Professional | None | $0.32 | $0.32 | $0.47 |
Select Health Setting Facility Modifier None Typical Low $0.45 Median $0.45 Typical High $0.60 | Facility | None | $0.45 | $0.45 | $0.60 |
Select Health Setting Professional Modifier None Typical Low $0.45 Median $0.49 Typical High $1.05 | Professional | None | $0.45 | $0.49 | $1.05 |
United Setting Professional Modifier None Typical Low $0.15 Median $0.19 Typical High $0.35 | Professional | None | $0.15 | $0.19 | $0.35 |
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 $0.30 Median $0.33 Typical High $0.35 | Professional | 78 · Unplanned return to OR | $0.30 | $0.33 | $0.35 |
Where Idaho sits
The same service costs 2.5 times more in Hawaii than in Utah. 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
$0.47
HI $0.48UT $0.19
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.