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 $2.82 Median $3.02 Typical High $3.80 | Facility | None | $2.82 | $3.02 | $3.80 |
Aetna Setting Professional Modifier None Typical Low $2.04 Median $2.51 Typical High $2.88 | Professional | None | $2.04 | $2.51 | $2.88 |
BCBS Idaho Setting Facility Modifier None Typical Low $1.82 Median $2.88 Typical High $4.47 | Facility | None | $1.82 | $2.88 | $4.47 |
BCBS Idaho Setting Professional Modifier None Typical Low $2.24 Median $2.45 Typical High $5.89 | Professional | None | $2.24 | $2.45 | $5.89 |
Moda Health Setting Facility Modifier None Typical Low $2.04 Median $2.51 Typical High $5.75 | Facility | None | $2.04 | $2.51 | $5.75 |
Moda Health Setting Professional Modifier None Typical Low $2.04 Median $2.51 Typical High $3.72 | Professional | None | $2.04 | $2.51 | $3.72 |
Molina Setting Professional Modifier None Typical Low $1.62 Median $1.62 Typical High $1.95 | Professional | None | $1.62 | $1.62 | $1.95 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $2.24 Median $2.29 Typical High $3.02 | Facility | None | $2.24 | $2.29 | $3.02 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1.95 Median $2.40 Typical High $2.51 | Professional | None | $1.95 | $2.40 | $2.51 |
Regence BlueShield Setting Professional Modifier None Typical Low $2.24 Median $2.45 Typical High $2.51 | Professional | None | $2.24 | $2.45 | $2.51 |
United Setting Professional Modifier None Typical Low $2.04 Median $2.04 Typical High $2.63 | Professional | None | $2.04 | $2.04 | $2.63 |
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 $1.02 Median $1.26 Typical High $1.26 | Professional | 52 · Reduced service | $1.02 | $1.26 | $1.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.41 Median $0.51 Typical High $0.51 | Professional | 53 · Discontinued | $0.41 | $0.51 | $0.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.31 Median $0.38 Typical High $0.38 | Professional | 55 · Aftercare only | $0.31 | $0.38 | $0.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.20 Median $0.25 Typical High $0.25 | Professional | 56 · Pre-op care only | $0.20 | $0.25 | $0.25 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1.48 Median $1.55 Typical High $4.07 | Professional | 78 · Unplanned return to OR | $1.48 | $1.55 | $4.07 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.12 Median $1.29 Typical High $1.29 | Professional | 52 · Reduced service | $1.12 | $1.29 | $1.29 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.45 Median $0.51 Typical High $0.51 | Professional | 53 · Discontinued | $0.45 | $0.51 | $0.51 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.34 Median $0.39 Typical High $0.39 | Professional | 55 · Aftercare only | $0.34 | $0.39 | $0.39 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.26 Typical High $0.26 | Professional | 56 · Pre-op care only | $0.22 | $0.26 | $0.26 |
Where Idaho sits
The same service costs 2.1 times more in Wyoming than in Delaware. 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
$2.45
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.