How much rates vary
Facilitymedian $4 · 10th to 90th $3 to $7Professionalmedian $3 · 10th to 90th $3 to $4
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 $4.37 Median $4.37 Typical High $5.50 | Facility | None | $4.37 | $4.37 | $5.50 |
Aetna Setting Professional Modifier None Typical Low $2.95 Median $3.72 Typical High $4.17 | Professional | None | $2.95 | $3.72 | $4.17 |
BCBS Idaho Setting Facility Modifier None Typical Low $2.19 Median $3.39 Typical High $6.61 | Facility | None | $2.19 | $3.39 | $6.61 |
BCBS Idaho Setting Professional Modifier None Typical Low $0.62 Median $3.24 Typical High $3.55 | Professional | None | $0.62 | $3.24 | $3.55 |
Cigna Setting Facility Modifier None Typical Low $4.07 Median $4.17 Typical High $7.41 | Facility | None | $4.07 | $4.17 | $7.41 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | None | $2.95 | $2.95 | $2.95 |
Moda Health Setting Facility Modifier None Typical Low $2.95 Median $3.72 Typical High $12.30 | Facility | None | $2.95 | $3.72 | $12.30 |
Moda Health Setting Professional Modifier None Typical Low $2.95 Median $3.39 Typical High $4.17 | Professional | None | $2.95 | $3.39 | $4.17 |
Molina Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $2.95 | Professional | None | $2.45 | $2.45 | $2.95 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $3.09 Median $3.24 Typical High $4.07 | Facility | None | $3.09 | $3.24 | $4.07 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2.63 Median $3.24 Typical High $3.63 | Professional | None | $2.63 | $3.24 | $3.63 |
Regence BlueShield Setting Professional Modifier None Typical Low $3.24 Median $3.55 Typical High $3.72 | Professional | None | $3.24 | $3.55 | $3.72 |
Select Health Setting Facility Modifier None Typical Low $2.95 Median $2.95 Typical High $7.41 | Facility | None | $2.95 | $2.95 | $7.41 |
Select Health Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $4.17 | Professional | None | $2.95 | $2.95 | $4.17 |
United Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $2.95 | Professional | None | $2.69 | $2.69 | $2.95 |
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 $1.48 Median $1.82 Typical High $1.82 | Professional | 52 · Reduced service | $1.48 | $1.82 | $1.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.59 Median $0.74 Typical High $0.74 | Professional | 53 · Discontinued | $0.59 | $0.74 | $0.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.45 Median $0.55 Typical High $0.55 | Professional | 55 · Aftercare only | $0.45 | $0.55 | $0.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.37 Typical High $0.37 | Professional | 56 · Pre-op care only | $0.30 | $0.37 | $0.37 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $0.43 Median $2.14 Typical High $2.29 | Professional | 78 · Unplanned return to OR | $0.43 | $2.14 | $2.29 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.45 Median $1.70 Typical High $1.70 | Professional | 52 · Reduced service | $1.45 | $1.70 | $1.70 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.58 Median $0.68 Typical High $0.68 | Professional | 53 · Discontinued | $0.58 | $0.68 | $0.68 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.44 Median $0.50 Typical High $0.50 | Professional | 55 · Aftercare only | $0.44 | $0.50 | $0.50 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.29 Median $0.34 Typical High $0.34 | Professional | 56 · Pre-op care only | $0.29 | $0.34 | $0.34 |
Where Idaho sits
Rates are fairly even across states for this service. 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· 3rd of 51
$3.24
AK $3.98NC $2.69
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.