How much rates vary
Facilitymedian $10 · 10th to 90th $7 to $14Professionalmedian $11 · 10th to 90th $7 to $19
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 $6.31 Median $7.41 Typical High $8.71 | Professional | None | $6.31 | $7.41 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.93 Median $1.12 Typical High $1.12 | Professional | 55 · Aftercare only | $0.93 | $1.12 | $1.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.63 Median $0.74 Typical High $0.76 | Professional | 56 · Pre-op care only | $0.63 | $0.74 | $0.76 |
BCBS Idaho Setting Professional Modifier None Typical Low $12.88 Median $16.60 Typical High $19.50 | Professional | None | $12.88 | $16.60 | $19.50 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $10.96 Median $13.18 Typical High $13.80 | Professional | 78 · Unplanned return to OR | $10.96 | $13.18 | $13.80 |
Cigna Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | None | $8.32 | $8.32 | $8.32 |
Moda Health Setting Facility Modifier None Typical Low $7.41 Median $7.76 Typical High $11.48 | Facility | None | $7.41 | $7.76 | $11.48 |
Moda Health Setting Professional Modifier None Typical Low $7.08 Median $7.41 Typical High $15.85 | Professional | None | $7.08 | $7.41 | $15.85 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.93 Median $1.12 Typical High $1.12 | Professional | 55 · Aftercare only | $0.93 | $1.12 | $1.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.63 Median $0.74 Typical High $0.74 | Professional | 56 · Pre-op care only | $0.63 | $0.74 | $0.74 |
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 $9.55 Median $10.72 Typical High $15.49 | Facility | None | $9.55 | $10.72 | $15.49 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $9.55 Median $10.72 Typical High $18.20 | Professional | None | $9.55 | $10.72 | $18.20 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $1.55 Median $1.55 Typical High $1.55 | Professional | 56 · Pre-op care only | $1.55 | $1.55 | $1.55 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $11.75 Median $11.75 Typical High $11.75 | Professional | 78 · Unplanned return to OR | $11.75 | $11.75 | $11.75 |
Regence BlueShield Setting Professional Modifier None Typical Low $10.96 Median $12.88 Typical High $13.49 | Professional | None | $10.96 | $12.88 | $13.49 |
Select Health Setting Facility Modifier None Typical Low $8.71 Median $8.71 Typical High $8.91 | Facility | None | $8.71 | $8.71 | $8.91 |
Select Health Setting Professional Modifier None Typical Low $8.13 Median $10.00 Typical High $16.22 | Professional | None | $8.13 | $10.00 | $16.22 |
United Setting Professional Modifier None Typical Low $9.33 Median $11.75 Typical High $15.49 | Professional | None | $9.33 | $11.75 | $15.49 |
3 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 |
|---|---|---|---|---|---|
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | 22 · Increased work | $16.98 | $16.98 | $16.98 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | 54 · Surgery only | $10.96 | $10.96 | $10.96 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | 63 · Small infant | $16.98 | $16.98 | $16.98 |
Where Idaho sits
The same service costs 2.6 times more in Alaska than in Florida. 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· 16th of 51
$11.22
AK $21.88FL $8.32
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.