How much rates vary
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 $1.45 Median $1.51 Typical High $1.91 | Facility | None | $1.45 | $1.51 | $1.91 |
Aetna Setting Professional Modifier None Typical Low $1.02 Median $1.26 Typical High $1.26 | Professional | None | $1.02 | $1.26 | $1.26 |
BCBS Idaho Setting Facility Modifier None Typical Low $0.87 Median $1.23 Typical High $2.04 | Facility | None | $0.87 | $1.23 | $2.04 |
BCBS Idaho Setting Professional Modifier None Typical Low $0.98 Median $1.12 Typical High $1.23 | Professional | None | $0.98 | $1.12 | $1.23 |
Moda Health Setting Facility Modifier None Typical Low $1.12 Median $1.51 Typical High $6.61 | Facility | None | $1.12 | $1.51 | $6.61 |
Moda Health Setting Professional Modifier None Typical Low $1.00 Median $1.12 Typical High $1.29 | Professional | None | $1.00 | $1.12 | $1.29 |
Molina Setting Professional Modifier None Typical Low $0.71 Median $0.71 Typical High $0.83 | Professional | None | $0.71 | $0.71 | $0.83 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $1.12 Median $1.15 Typical High $1.51 | Facility | None | $1.12 | $1.15 | $1.51 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1.00 Median $1.20 Typical High $1.26 | Professional | None | $1.00 | $1.20 | $1.26 |
Regence BlueShield Setting Professional Modifier None Typical Low $1.12 Median $1.23 Typical High $1.29 | Professional | None | $1.12 | $1.23 | $1.29 |
United Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $1.07 | Professional | None | $0.89 | $0.89 | $1.07 |
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 $0.52 Median $0.65 Typical High $0.65 | Professional | 52 · Reduced service | $0.52 | $0.65 | $0.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.21 Median $0.25 Typical High $0.25 | Professional | 53 · Discontinued | $0.21 | $0.25 | $0.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.15 Median $0.19 Typical High $0.19 | Professional | 55 · Aftercare only | $0.15 | $0.19 | $0.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.13 Typical High $0.13 | Professional | 56 · Pre-op care only | $0.10 | $0.13 | $0.13 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $0.66 Median $0.74 Typical High $0.78 | Professional | 78 · Unplanned return to OR | $0.66 | $0.74 | $0.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.49 Median $0.58 Typical High $0.58 | Professional | 52 · Reduced service | $0.49 | $0.58 | $0.58 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.20 Median $0.23 Typical High $0.23 | Professional | 53 · Discontinued | $0.20 | $0.23 | $0.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.15 Median $0.17 Typical High $0.17 | Professional | 55 · Aftercare only | $0.15 | $0.17 | $0.17 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.11 Typical High $0.11 | Professional | 56 · Pre-op care only | $0.10 | $0.11 | $0.11 |
Where Idaho sits
The same service costs 1.5 times more in Alaska than in New Mexico. 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· 5th of 51
$1.12
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.