How much rates vary
Facilitymedian $3 · 10th to 90th $2 to $5Professionalmedian $3 · 10th to 90th $1 to $4
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 $1.62 Median $3.89 Typical High $3.89 | Professional | None | $1.62 | $3.89 | $3.89 |
BCBS Idaho Setting Facility Modifier None Typical Low $2.04 Median $2.75 Typical High $5.13 | Facility | None | $2.04 | $2.75 | $5.13 |
BCBS Idaho Setting Professional Modifier None Typical Low $2.04 Median $3.09 Typical High $3.24 | Professional | None | $2.04 | $3.09 | $3.24 |
Cigna Setting Facility Modifier None Typical Low $1.74 Median $1.74 Typical High $1.86 | Facility | None | $1.74 | $1.74 | $1.86 |
Cigna Setting Professional Modifier None Typical Low $1.48 Median $1.48 Typical High $1.74 | Professional | None | $1.48 | $1.48 | $1.74 |
Moda Health Setting Facility Modifier None Typical Low $0.79 Median $2.82 Typical High $3.89 | Facility | None | $0.79 | $2.82 | $3.89 |
Moda Health Setting Professional Modifier None Typical Low $1.95 Median $3.09 Typical High $3.89 | Professional | None | $1.95 | $3.09 | $3.89 |
Molina Setting Professional Modifier None Typical Low $2.04 Median $2.04 Typical High $30.20 | Professional | None | $2.04 | $2.04 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $2.34 Median $3.63 Typical High $177.83 | Facility | None | $2.34 | $3.63 | $177.83 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2.95 Median $3.63 Typical High $208.93 | Professional | None | $2.95 | $3.63 | $208.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $2.04 Median $2.04 Typical High $3.09 | Professional | None | $2.04 | $2.04 | $3.09 |
Select Health Setting Facility Modifier None Typical Low $2.95 Median $2.95 Typical High $3.80 | Facility | None | $2.95 | $2.95 | $3.80 |
Select Health Setting Professional Modifier None Typical Low $1.91 Median $2.95 Typical High $3.24 | Professional | None | $1.91 | $2.95 | $3.24 |
United Setting Professional Modifier None Typical Low $1.12 Median $1.23 Typical High $2.14 | Professional | None | $1.12 | $1.23 | $2.14 |
9 more rates 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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.81 Median $1.95 Typical High $1.95 | Professional | 52 · Reduced service | $0.81 | $1.95 | $1.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.33 Median $0.78 Typical High $0.78 | Professional | 53 · Discontinued | $0.33 | $0.78 | $0.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.24 Median $0.59 Typical High $0.59 | Professional | 55 · Aftercare only | $0.24 | $0.59 | $0.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.16 Median $0.39 Typical High $0.39 | Professional | 56 · Pre-op care only | $0.16 | $0.39 | $0.39 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1.91 Median $2.14 Typical High $2.24 | Professional | 78 · Unplanned return to OR | $1.91 | $2.14 | $2.24 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.81 Median $1.95 Typical High $1.95 | Professional | 52 · Reduced service | $0.81 | $1.95 | $1.95 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.33 Median $0.78 Typical High $0.78 | Professional | 53 · Discontinued | $0.33 | $0.78 | $0.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.24 Median $0.59 Typical High $0.59 | Professional | 55 · Aftercare only | $0.24 | $0.59 | $0.59 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.16 Median $0.39 Typical High $0.39 | Professional | 56 · Pre-op care only | $0.16 | $0.39 | $0.39 |
Where Idaho sits
The same service costs 2.2 times more in Kansas than in Alabama. 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
$3.09
KS $3.31AL $1.48
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.