How much rates vary
Facilitymedian $4 · 10th to 90th $3 to $11Professionalmedian $3 · 10th to 90th $3 to $4
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 Facility Modifier None Typical Low $4.07 Median $4.27 Typical High $4.27 | Facility | None | $4.07 | $4.27 | $4.27 |
Aetna Setting Professional Modifier None Typical Low $2.88 Median $3.63 Typical High $3.63 | Professional | None | $2.88 | $3.63 | $3.63 |
BCBS Idaho Setting Facility Modifier None Typical Low $4.57 Median $10.96 Typical High $22.91 | Facility | None | $4.57 | $10.96 | $22.91 |
BCBS Idaho Setting Professional Modifier None Typical Low $3.16 Median $3.47 Typical High $11.22 | Professional | None | $3.16 | $3.47 | $11.22 |
Cigna Setting Facility Modifier None Typical Low $4.07 Median $4.07 Typical High $7.24 | Facility | None | $4.07 | $4.07 | $7.24 |
Cigna Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | None | $2.88 | $2.88 | $2.88 |
Moda Health Setting Facility Modifier None Typical Low $2.88 Median $3.63 Typical High $5.75 | Facility | None | $2.88 | $3.63 | $5.75 |
Moda Health Setting Professional Modifier None Typical Low $2.88 Median $3.63 Typical High $4.07 | Professional | None | $2.88 | $3.63 | $4.07 |
Molina Setting Professional Modifier None Typical Low $2.09 Median $2.45 Typical High $2.45 | Professional | None | $2.09 | $2.45 | $2.45 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $3.16 Median $3.80 Typical High $5.01 | Facility | None | $3.16 | $3.80 | $5.01 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $3.31 Median $3.63 Typical High $3.98 | Professional | None | $3.31 | $3.63 | $3.98 |
Regence BlueShield Setting Professional Modifier None Typical Low $3.16 Median $3.47 Typical High $3.63 | Professional | None | $3.16 | $3.47 | $3.63 |
Select Health Setting Facility Modifier None Typical Low $2.88 Median $2.88 Typical High $6.03 | Facility | None | $2.88 | $2.88 | $6.03 |
Select Health Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $4.07 | Professional | None | $2.88 | $2.88 | $4.07 |
United Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.47 | Professional | None | $3.24 | $3.24 | $3.47 |
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 $1.45 Median $1.82 Typical High $1.82 | Professional | 52 · Reduced service | $1.45 | $1.82 | $1.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.58 Median $0.72 Typical High $0.72 | Professional | 53 · Discontinued | $0.58 | $0.72 | $0.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.44 Median $0.54 Typical High $0.54 | Professional | 55 · Aftercare only | $0.44 | $0.54 | $0.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.36 Typical High $0.36 | Professional | 56 · Pre-op care only | $0.28 | $0.36 | $0.36 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2.09 Median $2.24 Typical High $7.59 | Professional | 78 · Unplanned return to OR | $2.09 | $2.24 | $7.59 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.78 Median $2.04 Typical High $2.04 | Professional | 52 · Reduced service | $1.78 | $2.04 | $2.04 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.71 Median $0.81 Typical High $0.81 | Professional | 53 · Discontinued | $0.71 | $0.81 | $0.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.62 Typical High $0.62 | Professional | 55 · Aftercare only | $0.52 | $0.62 | $0.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.35 Median $0.41 Typical High $0.41 | Professional | 56 · Pre-op care only | $0.35 | $0.41 | $0.41 |
Where Idaho sits
The same service costs 3.1 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· 9th of 51
$3.47
WY $8.91DE $2.88
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.