How much rates vary
Facilitymedian $2 · 10th to 90th $1 to $7Professionalmedian $2 · 10th to 90th $1 to $2
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 $1.32 Median $1.62 Typical High $1.62 | Professional | None | $1.32 | $1.62 | $1.62 |
BCBS Idaho Setting Facility Modifier None Typical Low $2.09 Median $5.50 Typical High $8.13 | Facility | None | $2.09 | $5.50 | $8.13 |
BCBS Idaho Setting Professional Modifier None Typical Low $1.45 Median $1.45 Typical High $4.79 | Professional | None | $1.45 | $1.45 | $4.79 |
Cigna Setting Facility Modifier None Typical Low $1.82 Median $1.86 Typical High $3.31 | Facility | None | $1.82 | $1.86 | $3.31 |
Cigna Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | None | $1.29 | $1.29 | $1.29 |
Moda Health Setting Facility Modifier None Typical Low $1.32 Median $1.62 Typical High $1.66 | Facility | None | $1.32 | $1.62 | $1.66 |
Moda Health Setting Professional Modifier None Typical Low $1.32 Median $1.62 Typical High $1.66 | Professional | None | $1.32 | $1.62 | $1.66 |
Molina Setting Professional Modifier None Typical Low $1.15 Median $1.15 Typical High $1.35 | Professional | None | $1.15 | $1.15 | $1.35 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $1.45 Median $1.55 Typical High $2.04 | Facility | None | $1.45 | $1.55 | $2.04 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1.32 Median $1.58 Typical High $1.62 | Professional | None | $1.32 | $1.58 | $1.62 |
Regence BlueShield Setting Professional Modifier None Typical Low $1.45 Median $1.58 Typical High $1.62 | Professional | None | $1.45 | $1.58 | $1.62 |
Select Health Setting Facility Modifier None Typical Low $1.32 Median $1.32 Typical High $2.75 | Facility | None | $1.32 | $1.32 | $2.75 |
Select Health Setting Professional Modifier None Typical Low $1.29 Median $1.32 Typical High $1.66 | Professional | None | $1.29 | $1.32 | $1.66 |
United Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.48 | Professional | None | $1.32 | $1.32 | $1.48 |
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 $0.66 Median $0.81 Typical High $0.81 | Professional | 52 · Reduced service | $0.66 | $0.81 | $0.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.26 Median $0.33 Typical High $0.33 | Professional | 53 · Discontinued | $0.26 | $0.33 | $0.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.20 Median $0.24 Typical High $0.24 | Professional | 55 · Aftercare only | $0.20 | $0.24 | $0.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.16 Typical High $0.16 | Professional | 56 · Pre-op care only | $0.13 | $0.16 | $0.16 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $0.95 Median $1.00 Typical High $3.39 | Professional | 78 · Unplanned return to OR | $0.95 | $1.00 | $3.39 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.72 Median $0.83 Typical High $0.83 | Professional | 52 · Reduced service | $0.72 | $0.83 | $0.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.29 Median $0.33 Typical High $0.33 | Professional | 53 · Discontinued | $0.29 | $0.33 | $0.33 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.22 Median $0.25 Typical High $0.25 | Professional | 55 · Aftercare only | $0.22 | $0.25 | $0.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.15 Median $0.17 Typical High $0.17 | Professional | 56 · Pre-op care only | $0.15 | $0.17 | $0.17 |
Where Idaho sits
The same service costs 1.9 times more in Wyoming than in Florida. 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· 7th of 51
$1.55
WY $2.45FL $1.32
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.