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 $0.07 Median $0.08 Typical High $0.10 | Facility | None | $0.07 | $0.08 | $0.10 |
Aetna Setting Professional Modifier None Typical Low $0.06 Median $0.07 Typical High $0.07 | Professional | None | $0.06 | $0.07 | $0.07 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.03 Median $0.04 Typical High $0.04 | Professional | 52 · Reduced service | $0.03 | $0.04 | $0.04 |
BCBS Setting Facility Modifier None Typical Low $0.38 Median $9.12 Typical High $12.88 | Facility | None | $0.38 | $9.12 | $12.88 |
BCBS Setting Professional Modifier None Typical Low $0.06 Median $0.07 Typical High $0.51 | Professional | None | $0.06 | $0.07 | $0.51 |
Cigna Setting Facility Modifier None Typical Low $0.08 Median $0.08 Typical High $0.15 | Facility | None | $0.08 | $0.08 | $0.15 |
Cigna Setting Professional Modifier None Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | None | $0.06 | $0.06 | $0.06 |
Moda Health Setting Facility Modifier None Typical Low $0.07 Median $0.09 Typical High $5.37 | Facility | None | $0.07 | $0.09 | $5.37 |
Moda Health Setting Professional Modifier None Typical Low $0.06 Median $0.09 Typical High $0.10 | Professional | None | $0.06 | $0.09 | $0.10 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 52 · Reduced service | $0.05 | $0.05 | $0.05 |
Molina Setting Professional Modifier None Typical Low $0.06 Median $0.07 Typical High $0.07 | Professional | None | $0.06 | $0.07 | $0.07 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $0.07 Median $0.38 Typical High $0.51 | Facility | None | $0.07 | $0.38 | $0.51 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $0.07 Median $0.33 Typical High $0.40 | Professional | None | $0.07 | $0.33 | $0.40 |
Regence BlueShield Setting Facility Modifier None Typical Low $0.59 Median $0.59 Typical High $0.59 | Facility | None | $0.59 | $0.59 | $0.59 |
Regence BlueShield Setting Professional Modifier None Typical Low $0.07 Median $0.07 Typical High $0.08 | Professional | None | $0.07 | $0.07 | $0.08 |
Select Health Setting Facility Modifier None Typical Low $0.06 Median $0.06 Typical High $3.89 | Facility | None | $0.06 | $0.06 | $3.89 |
Select Health Setting Professional Modifier None Typical Low $0.06 Median $0.06 Typical High $0.09 | Professional | None | $0.06 | $0.06 | $0.09 |
United Setting Professional Modifier None Typical Low $0.08 Median $0.08 Typical High $0.13 | Professional | None | $0.08 | $0.08 | $0.13 |
3 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 |
|---|---|---|---|---|---|
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $0.04 Median $0.31 Typical High $0.36 | Professional | 78 · Unplanned return to OR | $0.04 | $0.31 | $0.36 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 53 · Discontinued | $0.02 | $0.02 | $0.02 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $0.02 |
Where Idaho sits
The same service costs 8.5 times more in Wyoming than in Maine. 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· 19th of 51
$0.07
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.