How much rates vary
Facilitymedian $2 · 10th to 90th $1 to $66Professionalmedian $2 · 10th to 90th $1 to $2
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 $1.00 Median $2.40 Typical High $2.40 | Professional | None | $1.00 | $2.40 | $2.40 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.50 Median $1.20 Typical High $1.20 | Professional | 52 · Reduced service | $0.50 | $1.20 | $1.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.20 Median $0.48 Typical High $0.48 | Professional | 53 · Discontinued | $0.20 | $0.48 | $0.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.15 Median $0.36 Typical High $0.36 | Professional | 55 · Aftercare only | $0.15 | $0.36 | $0.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.24 Typical High $0.24 | Professional | 56 · Pre-op care only | $0.10 | $0.24 | $0.24 |
BCBS Idaho Setting Facility Modifier None Typical Low $1.23 Median $1.70 Typical High $2.82 | Facility | None | $1.23 | $1.70 | $2.82 |
BCBS Idaho Setting Professional Modifier None Typical Low $1.26 Median $1.86 Typical High $1.95 | Professional | None | $1.26 | $1.86 | $1.95 |
Cigna Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $0.89 | Professional | None | $0.89 | $0.89 | $0.89 |
Moda Health Setting Facility Modifier None Typical Low $1.58 Median $1.70 Typical High $2.40 | Facility | None | $1.58 | $1.70 | $2.40 |
Moda Health Setting Professional Modifier None Typical Low $1.00 Median $1.86 Typical High $2.40 | Professional | None | $1.00 | $1.86 | $2.40 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.50 Median $1.20 Typical High $1.20 | Professional | 52 · Reduced service | $0.50 | $1.20 | $1.20 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.20 Median $0.48 Typical High $0.48 | Professional | 53 · Discontinued | $0.20 | $0.48 | $0.48 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.15 Median $0.36 Typical High $0.36 | Professional | 55 · Aftercare only | $0.15 | $0.36 | $0.36 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.24 Typical High $0.24 | Professional | 56 · Pre-op care only | $0.10 | $0.24 | $0.24 |
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 $2.24 Median $66.07 Typical High $107.15 | Facility | None | $2.24 | $66.07 | $107.15 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1.86 Median $2.24 Typical High $125.89 | Professional | None | $1.86 | $2.24 | $125.89 |
Regence BlueShield Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.86 | Professional | None | $1.26 | $1.26 | $1.86 |
Select Health Setting Facility Modifier None Typical Low $1.78 Median $1.78 Typical High $2.34 | Facility | None | $1.78 | $1.78 | $2.34 |
Select Health Setting Professional Modifier None Typical Low $1.78 Median $1.95 Typical High $4.17 | Professional | None | $1.78 | $1.95 | $4.17 |
United Setting Professional Modifier None Typical Low $0.58 Median $0.76 Typical High $1.10 | Professional | None | $0.58 | $0.76 | $1.10 |
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 $1.17 Median $1.32 Typical High $1.38 | Professional | 78 · Unplanned return to OR | $1.17 | $1.32 | $1.38 |
Where Idaho sits
The same service costs 2.5 times more in Idaho 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· 1st of 51
$1.86
ID $1.86CO $0.76
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.