How much rates vary
Facilitymedian $1 · 10th to 90th $0 to $20Professionalmedian $1 · 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 $0.31 Median $0.74 Typical High $0.74 | Professional | None | $0.31 | $0.74 | $0.74 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.16 Median $0.37 Typical High $0.37 | Professional | 52 · Reduced service | $0.16 | $0.37 | $0.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.06 Median $0.15 Typical High $0.15 | Professional | 53 · Discontinued | $0.06 | $0.15 | $0.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.11 Typical High $0.11 | Professional | 55 · Aftercare only | $0.05 | $0.11 | $0.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.07 Typical High $0.07 | Professional | 56 · Pre-op care only | $0.03 | $0.07 | $0.07 |
BCBS Idaho Setting Facility Modifier None Typical Low $0.42 Median $0.58 Typical High $1.02 | Facility | None | $0.42 | $0.58 | $1.02 |
BCBS Idaho Setting Professional Modifier None Typical Low $0.39 Median $0.58 Typical High $0.62 | Professional | None | $0.39 | $0.58 | $0.62 |
Cigna Setting Professional Modifier None Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | None | $0.28 | $0.28 | $0.28 |
Moda Health Setting Facility Modifier None Typical Low $0.51 Median $0.52 Typical High $0.74 | Facility | None | $0.51 | $0.52 | $0.74 |
Moda Health Setting Professional Modifier None Typical Low $0.31 Median $0.58 Typical High $0.74 | Professional | None | $0.31 | $0.58 | $0.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.16 Median $0.37 Typical High $0.37 | Professional | 52 · Reduced service | $0.16 | $0.37 | $0.37 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.06 Median $0.15 Typical High $0.15 | Professional | 53 · Discontinued | $0.06 | $0.15 | $0.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.11 Typical High $0.11 | Professional | 55 · Aftercare only | $0.05 | $0.11 | $0.11 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.07 Typical High $0.07 | Professional | 56 · Pre-op care only | $0.03 | $0.07 | $0.07 |
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 $0.69 Median $20.42 Typical High $33.11 | Facility | None | $0.69 | $20.42 | $33.11 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $0.58 Median $0.69 Typical High $38.90 | Professional | None | $0.58 | $0.69 | $38.90 |
Regence BlueShield Setting Professional Modifier None Typical Low $0.39 Median $0.39 Typical High $0.58 | Professional | None | $0.39 | $0.39 | $0.58 |
Select Health Setting Facility Modifier None Typical Low $0.55 Median $0.55 Typical High $0.74 | Facility | None | $0.55 | $0.55 | $0.74 |
Select Health Setting Professional Modifier None Typical Low $0.55 Median $0.60 Typical High $1.29 | Professional | None | $0.55 | $0.60 | $1.29 |
United Setting Professional Modifier None Typical Low $0.18 Median $0.23 Typical High $0.45 | Professional | None | $0.18 | $0.23 | $0.45 |
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 $0.37 Median $0.41 Typical High $0.43 | Professional | 78 · Unplanned return to OR | $0.37 | $0.41 | $0.43 |
Where Idaho sits
The same service costs 2.6 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
$0.58
HI $0.59UT $0.23
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.