How much rates vary
Facilitymedian $10 · 10th to 90th $5 to $20Professionalmedian $9 · 10th to 90th $5 to $14
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 $9.12 Median $9.33 Typical High $9.33 | Professional | None | $9.12 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $4.57 Median $4.68 Typical High $4.68 | Professional | 52 · Reduced service | $4.57 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.82 Median $1.91 Typical High $1.91 | Professional | 53 · Discontinued | $1.82 | $1.91 | $1.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.38 Median $1.41 Typical High $1.41 | Professional | 55 · Aftercare only | $1.38 | $1.41 | $1.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.91 Median $0.95 Typical High $0.95 | Professional | 56 · Pre-op care only | $0.91 | $0.95 | $0.95 |
BCBS Idaho Setting Facility Modifier None Typical Low $6.92 Median $10.47 Typical High $21.38 | Facility | None | $6.92 | $10.47 | $21.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $13.80 | Professional | None | $10.47 | $10.47 | $13.80 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $6.92 Median $7.24 Typical High $9.55 | Professional | 78 · Unplanned return to OR | $6.92 | $7.24 | $9.55 |
Cigna Setting Facility Modifier None Typical Low $10.23 Median $13.18 Typical High $25.12 | Facility | None | $10.23 | $13.18 | $25.12 |
Cigna Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | None | $9.33 | $9.33 | $9.33 |
Moda Health Setting Facility Modifier None Typical Low $2.88 Median $9.55 Typical High $13.49 | Facility | None | $2.88 | $9.55 | $13.49 |
Moda Health Setting Professional Modifier None Typical Low $9.12 Median $9.55 Typical High $9.55 | Professional | None | $9.12 | $9.55 | $9.55 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $4.57 Median $4.68 Typical High $4.68 | Professional | 52 · Reduced service | $4.57 | $4.68 | $4.68 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.82 Median $1.91 Typical High $1.91 | Professional | 53 · Discontinued | $1.82 | $1.91 | $1.91 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.38 Median $1.41 Typical High $1.41 | Professional | 55 · Aftercare only | $1.38 | $1.41 | $1.41 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.91 Median $0.95 Typical High $0.95 | Professional | 56 · Pre-op care only | $0.91 | $0.95 | $0.95 |
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 $4.79 Median $5.37 Typical High $7.76 | Facility | None | $4.79 | $5.37 | $7.76 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $4.57 Median $5.37 Typical High $9.12 | Professional | None | $4.57 | $5.37 | $9.12 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $1.38 Median $1.38 Typical High $1.38 | Professional | 56 · Pre-op care only | $1.38 | $1.38 | $1.38 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | 78 · Unplanned return to OR | $10.23 | $10.23 | $10.23 |
Regence BlueShield Setting Facility Modifier None Typical Low $6.92 Median $7.41 Typical High $11.22 | Facility | None | $6.92 | $7.41 | $11.22 |
Select Health Setting Facility Modifier None Typical Low $16.60 Median $19.50 Typical High $27.54 | Facility | None | $16.60 | $19.50 | $27.54 |
Select Health Setting Professional Modifier None Typical Low $10.96 Median $13.80 Typical High $13.80 | Professional | None | $10.96 | $13.80 | $13.80 |
United Setting Professional Modifier None Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | None | $9.12 | $9.12 | $9.12 |
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 $15.14 Median $15.14 Typical High $15.14 | Professional | 22 · Increased work | $15.14 | $15.14 | $15.14 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | 54 · Surgery only | $9.55 | $9.55 | $9.55 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 63 · Small infant | $15.14 | $15.14 | $15.14 |
Where Idaho sits
The same service costs 1.8 times more in Alaska than in Montana. 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· 27th of 51
$9.33
AK $13.80MT $7.59
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.