How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $1.38 Median $3.31 Typical High $3.31 | Professional | None | $1.38 | $3.31 | $3.31 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.71 Median $1.66 Typical High $1.66 | Professional | 52 · Reduced service | $0.71 | $1.66 | $1.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.28 Median $0.66 Typical High $0.66 | Professional | 53 · Discontinued | $0.28 | $0.66 | $0.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.21 Median $0.50 Typical High $0.50 | Professional | 55 · Aftercare only | $0.21 | $0.50 | $0.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.33 Typical High $0.33 | Professional | 56 · Pre-op care only | $0.14 | $0.33 | $0.33 |
BCBS Idaho Setting Facility Modifier None Typical Low $0.59 Median $3.39 Typical High $4.90 | Facility | None | $0.59 | $3.39 | $4.90 |
BCBS Idaho Setting Professional Modifier None Typical Low $1.74 Median $2.63 Typical High $2.75 | Professional | None | $1.74 | $2.63 | $2.75 |
Cigna Setting Professional Modifier None Typical Low $1.02 Median $1.12 Typical High $1.12 | Professional | None | $1.02 | $1.12 | $1.12 |
Moda Health Setting Facility Modifier None Typical Low $1.38 Median $2.40 Typical High $3.31 | Facility | None | $1.38 | $2.40 | $3.31 |
Moda Health Setting Professional Modifier None Typical Low $1.74 Median $2.63 Typical High $3.31 | Professional | None | $1.74 | $2.63 | $3.31 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.71 Median $1.66 Typical High $1.66 | Professional | 52 · Reduced service | $0.71 | $1.66 | $1.66 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.28 Median $0.66 Typical High $0.66 | Professional | 53 · Discontinued | $0.28 | $0.66 | $0.66 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.21 Median $0.50 Typical High $0.50 | Professional | 55 · Aftercare only | $0.21 | $0.50 | $0.50 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.33 Typical High $0.33 | Professional | 56 · Pre-op care only | $0.14 | $0.33 | $0.33 |
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 $3.09 Median $91.20 Typical High $151.36 | Facility | None | $3.09 | $91.20 | $151.36 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2.63 Median $3.09 Typical High $177.83 | Professional | None | $2.63 | $3.09 | $177.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $2.63 | Professional | None | $1.74 | $1.74 | $2.63 |
Select Health Setting Facility Modifier None Typical Low $2.51 Median $2.51 Typical High $2.51 | Facility | None | $2.51 | $2.51 | $2.51 |
Select Health Setting Professional Modifier None Typical Low $2.51 Median $2.75 Typical High $5.89 | Professional | None | $2.51 | $2.75 | $5.89 |
United Setting Professional Modifier None Typical Low $0.81 Median $1.05 Typical High $1.55 | Professional | None | $0.81 | $1.05 | $1.55 |
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 $1.62 Median $1.82 Typical High $1.95 | Professional | 78 · Unplanned return to OR | $1.62 | $1.82 | $1.95 |
Where Idaho sits
The same service costs 4.6 times more in Rhode Island 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· 4th of 51
$2.51
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.