How much rates vary
Facilitymedian $1 · 10th to 90th $1 to $33Professionalmedian $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 Facility Modifier None Typical Low $1.23 Median $1.23 Typical High $1.23 | Facility | None | $1.23 | $1.23 | $1.23 |
Aetna Setting Professional Modifier None Typical Low $0.50 Median $1.20 Typical High $1.20 | Professional | None | $0.50 | $1.20 | $1.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.25 Median $0.60 Typical High $0.60 | Professional | 52 · Reduced service | $0.25 | $0.60 | $0.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.10 Median $0.24 Typical High $0.24 | Professional | 53 · Discontinued | $0.10 | $0.24 | $0.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.08 Median $0.18 Typical High $0.18 | Professional | 55 · Aftercare only | $0.08 | $0.18 | $0.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.12 Typical High $0.12 | Professional | 56 · Pre-op care only | $0.05 | $0.12 | $0.12 |
BCBS Idaho Setting Facility Modifier None Typical Low $0.63 Median $0.85 Typical High $1.45 | Facility | None | $0.63 | $0.85 | $1.45 |
BCBS Idaho Setting Professional Modifier None Typical Low $0.63 Median $0.95 Typical High $1.00 | Professional | None | $0.63 | $0.95 | $1.00 |
Cigna Setting Professional Modifier None Typical Low $0.45 Median $0.45 Typical High $0.45 | Professional | None | $0.45 | $0.45 | $0.45 |
Moda Health Setting Facility Modifier None Typical Low $0.76 Median $0.89 Typical High $1.70 | Facility | None | $0.76 | $0.89 | $1.70 |
Moda Health Setting Professional Modifier None Typical Low $0.50 Median $0.95 Typical High $1.20 | Professional | None | $0.50 | $0.95 | $1.20 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.25 Median $0.60 Typical High $0.60 | Professional | 52 · Reduced service | $0.25 | $0.60 | $0.60 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.10 Median $0.24 Typical High $0.24 | Professional | 53 · Discontinued | $0.10 | $0.24 | $0.24 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.08 Median $0.18 Typical High $0.18 | Professional | 55 · Aftercare only | $0.08 | $0.18 | $0.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.12 Typical High $0.12 | Professional | 56 · Pre-op care only | $0.05 | $0.12 | $0.12 |
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 $1.12 Median $33.11 Typical High $53.70 | Facility | None | $1.12 | $33.11 | $53.70 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $0.95 Median $1.12 Typical High $63.10 | Professional | None | $0.95 | $1.12 | $63.10 |
Regence BlueShield Setting Professional Modifier None Typical Low $0.63 Median $0.63 Typical High $0.95 | Professional | None | $0.63 | $0.63 | $0.95 |
Select Health Setting Facility Modifier None Typical Low $0.89 Median $0.89 Typical High $1.12 | Facility | None | $0.89 | $0.89 | $1.12 |
Select Health Setting Professional Modifier None Typical Low $0.89 Median $0.98 Typical High $2.09 | Professional | None | $0.89 | $0.98 | $2.09 |
United Setting Professional Modifier None Typical Low $0.28 Median $0.37 Typical High $0.56 | Professional | None | $0.28 | $0.37 | $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 $0.59 Median $0.68 Typical High $0.69 | Professional | 78 · Unplanned return to OR | $0.59 | $0.68 | $0.69 |
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
$0.95
HI $0.98UT $0.37
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.