How much rates vary
Facilitymedian $1 · 10th to 90th $1 to $35Professionalmedian $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 $0.54 Median $1.29 Typical High $1.29 | Professional | None | $0.54 | $1.29 | $1.29 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.27 Median $0.65 Typical High $0.65 | Professional | 52 · Reduced service | $0.27 | $0.65 | $0.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.11 Median $0.26 Typical High $0.26 | Professional | 53 · Discontinued | $0.11 | $0.26 | $0.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.08 Median $0.20 Typical High $0.20 | Professional | 55 · Aftercare only | $0.08 | $0.20 | $0.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.13 Typical High $0.13 | Professional | 56 · Pre-op care only | $0.05 | $0.13 | $0.13 |
BCBS Idaho Setting Facility Modifier None Typical Low $0.59 Median $0.89 Typical High $1.55 | Facility | None | $0.59 | $0.89 | $1.55 |
BCBS Idaho Setting Professional Modifier None Typical Low $0.68 Median $1.02 Typical High $1.07 | Professional | None | $0.68 | $1.02 | $1.07 |
Cigna Setting Professional Modifier None Typical Low $0.49 Median $0.49 Typical High $0.49 | Professional | None | $0.49 | $0.49 | $0.49 |
Moda Health Setting Facility Modifier None Typical Low $0.83 Median $0.91 Typical High $1.29 | Facility | None | $0.83 | $0.91 | $1.29 |
Moda Health Setting Professional Modifier None Typical Low $0.54 Median $1.02 Typical High $1.29 | Professional | None | $0.54 | $1.02 | $1.29 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.27 Median $0.65 Typical High $0.65 | Professional | 52 · Reduced service | $0.27 | $0.65 | $0.65 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.11 Median $0.26 Typical High $0.26 | Professional | 53 · Discontinued | $0.11 | $0.26 | $0.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.08 Median $0.20 Typical High $0.20 | Professional | 55 · Aftercare only | $0.08 | $0.20 | $0.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.13 Typical High $0.13 | Professional | 56 · Pre-op care only | $0.05 | $0.13 | $0.13 |
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 $1.20 Median $35.48 Typical High $57.54 | Facility | None | $1.20 | $35.48 | $57.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1.02 Median $1.20 Typical High $67.61 | Professional | None | $1.02 | $1.20 | $67.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $0.68 Median $0.68 Typical High $1.02 | Professional | None | $0.68 | $0.68 | $1.02 |
Select Health Setting Facility Modifier None Typical Low $0.98 Median $0.98 Typical High $1.20 | Facility | None | $0.98 | $0.98 | $1.20 |
Select Health Setting Professional Modifier None Typical Low $0.98 Median $1.07 Typical High $2.24 | Professional | None | $0.98 | $1.07 | $2.24 |
United Setting Professional Modifier None Typical Low $0.32 Median $0.41 Typical High $0.56 | Professional | None | $0.32 | $0.41 | $0.56 |
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 $0.65 Median $0.71 Typical High $0.76 | Professional | 78 · Unplanned return to OR | $0.65 | $0.71 | $0.76 |
Where Idaho sits
The same service costs 2.6 times more in Hawaii than in Colorado. 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
$1.02
HI $1.05CO $0.41
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.