How much rates vary
Facilitymedian $3 · 10th to 90th $2 to $6Professionalmedian $2 · 10th to 90th $2 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 Facility Modifier None Typical Low $3.02 Median $3.16 Typical High $3.98 | Facility | None | $3.02 | $3.16 | $3.98 |
Aetna Setting Professional Modifier None Typical Low $2.14 Median $2.63 Typical High $2.63 | Professional | None | $2.14 | $2.63 | $2.63 |
BCBS Idaho Setting Facility Modifier None Typical Low $2.34 Median $3.39 Typical High $5.62 | Facility | None | $2.34 | $3.39 | $5.62 |
BCBS Idaho Setting Professional Modifier None Typical Low $2.34 Median $2.57 Typical High $4.07 | Professional | None | $2.34 | $2.57 | $4.07 |
Cigna Setting Facility Modifier None Typical Low $2.95 Median $3.02 Typical High $5.37 | Facility | None | $2.95 | $3.02 | $5.37 |
Cigna Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $2.14 | Professional | None | $2.14 | $2.14 | $2.14 |
Moda Health Setting Facility Modifier None Typical Low $2.40 Median $2.69 Typical High $15.14 | Facility | None | $2.40 | $2.69 | $15.14 |
Moda Health Setting Professional Modifier None Typical Low $2.14 Median $2.63 Typical High $3.80 | Professional | None | $2.14 | $2.63 | $3.80 |
Molina Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $2.34 | Professional | None | $1.95 | $1.95 | $2.34 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $2.29 Median $2.34 Typical High $3.02 | Facility | None | $2.29 | $2.34 | $3.02 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1.95 Median $2.40 Typical High $2.63 | Professional | None | $1.95 | $2.40 | $2.63 |
Regence BlueShield Setting Professional Modifier None Typical Low $2.34 Median $2.57 Typical High $2.63 | Professional | None | $2.34 | $2.57 | $2.63 |
Select Health Setting Facility Modifier None Typical Low $2.14 Median $2.14 Typical High $4.57 | Facility | None | $2.14 | $2.14 | $4.57 |
Select Health Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $2.19 | Professional | None | $2.14 | $2.14 | $2.19 |
United Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $3.24 | Professional | None | $2.19 | $2.19 | $3.24 |
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 $1.07 Median $1.32 Typical High $1.32 | Professional | 52 · Reduced service | $1.07 | $1.32 | $1.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.43 Median $0.52 Typical High $0.52 | Professional | 53 · Discontinued | $0.43 | $0.52 | $0.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.32 Median $0.40 Typical High $0.40 | Professional | 55 · Aftercare only | $0.32 | $0.40 | $0.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.27 Typical High $0.27 | Professional | 56 · Pre-op care only | $0.22 | $0.27 | $0.27 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1.62 Median $2.75 Typical High $2.88 | Professional | 78 · Unplanned return to OR | $1.62 | $2.75 | $2.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.17 Median $1.35 Typical High $1.35 | Professional | 52 · Reduced service | $1.17 | $1.35 | $1.35 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.47 Median $0.54 Typical High $0.54 | Professional | 53 · Discontinued | $0.47 | $0.54 | $0.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.35 Median $0.41 Typical High $0.41 | Professional | 55 · Aftercare only | $0.35 | $0.41 | $0.41 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.24 Median $0.27 Typical High $0.27 | Professional | 56 · Pre-op care only | $0.24 | $0.27 | $0.27 |
Where Idaho sits
The same service costs 1.9 times more in Wyoming than in Maine. 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· 6th of 51
$2.57
WY $4.07ME $2.14
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.