How much rates vary
Facilitymedian $2 · 10th to 90th $2 to $74Professionalmedian $2 · 10th to 90th $1 to $3
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 $1.10 Median $2.63 Typical High $2.63 | Professional | None | $1.10 | $2.63 | $2.63 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.55 Median $1.32 Typical High $1.32 | Professional | 52 · Reduced service | $0.55 | $1.32 | $1.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.22 Median $0.52 Typical High $0.52 | Professional | 53 · Discontinued | $0.22 | $0.52 | $0.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.17 Median $0.40 Typical High $0.40 | Professional | 55 · Aftercare only | $0.17 | $0.40 | $0.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.26 Typical High $0.26 | Professional | 56 · Pre-op care only | $0.11 | $0.26 | $0.26 |
BCBS Idaho Setting Facility Modifier None Typical Low $1.41 Median $1.86 Typical High $3.16 | Facility | None | $1.41 | $1.86 | $3.16 |
BCBS Idaho Setting Professional Modifier None Typical Low $1.38 Median $2.09 Typical High $2.19 | Professional | None | $1.38 | $2.09 | $2.19 |
Cigna Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | None | $1.00 | $1.00 | $1.00 |
Moda Health Setting Facility Modifier None Typical Low $1.74 Median $1.91 Typical High $2.63 | Facility | None | $1.74 | $1.91 | $2.63 |
Moda Health Setting Professional Modifier None Typical Low $1.10 Median $2.09 Typical High $2.63 | Professional | None | $1.10 | $2.09 | $2.63 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.55 Median $1.32 Typical High $1.32 | Professional | 52 · Reduced service | $0.55 | $1.32 | $1.32 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.22 Median $0.52 Typical High $0.52 | Professional | 53 · Discontinued | $0.22 | $0.52 | $0.52 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.17 Median $0.40 Typical High $0.40 | Professional | 55 · Aftercare only | $0.17 | $0.40 | $0.40 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.26 Typical High $0.26 | Professional | 56 · Pre-op care only | $0.11 | $0.26 | $0.26 |
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 $2.51 Median $74.13 Typical High $120.23 | Facility | None | $2.51 | $74.13 | $120.23 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2.09 Median $2.51 Typical High $141.25 | Professional | None | $2.09 | $2.51 | $141.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $2.09 | Professional | None | $1.38 | $1.38 | $2.09 |
Select Health Setting Facility Modifier None Typical Low $2.00 Median $2.00 Typical High $2.57 | Facility | None | $2.00 | $2.00 | $2.57 |
Select Health Setting Professional Modifier None Typical Low $2.00 Median $2.19 Typical High $4.68 | Professional | None | $2.00 | $2.19 | $4.68 |
United Setting Professional Modifier None Typical Low $0.65 Median $0.83 Typical High $1.29 | Professional | None | $0.65 | $0.83 | $1.29 |
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 $1.29 Median $1.45 Typical High $1.51 | Professional | 78 · Unplanned return to OR | $1.29 | $1.45 | $1.51 |
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
$2.09
HI $2.14UT $0.83
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.