How much rates vary
Facilitymedian $0 · 10th to 90th $0 to $2Professionalmedian $0 · 10th to 90th $0 to $0
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 $0.15 Median $0.16 Typical High $0.21 | Facility | None | $0.15 | $0.16 | $0.21 |
Aetna Setting Professional Modifier None Typical Low $0.11 Median $0.14 Typical High $0.14 | Professional | None | $0.11 | $0.14 | $0.14 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.06 Median $0.07 Typical High $0.07 | Professional | 52 · Reduced service | $0.06 | $0.07 | $0.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.02 Median $0.03 Typical High $0.03 | Professional | 53 · Discontinued | $0.02 | $0.03 | $0.03 |
BCBS Idaho Setting Facility Modifier None Typical Low $0.18 Median $0.63 Typical High $2.14 | Facility | None | $0.18 | $0.63 | $2.14 |
BCBS Idaho Setting Professional Modifier None Typical Low $0.12 Median $0.13 Typical High $0.34 | Professional | None | $0.12 | $0.13 | $0.34 |
Cigna Setting Facility Modifier None Typical Low $0.15 Median $0.17 Typical High $0.28 | Facility | None | $0.15 | $0.17 | $0.28 |
Cigna Setting Professional Modifier None Typical Low $0.11 Median $0.11 Typical High $0.11 | Professional | None | $0.11 | $0.11 | $0.11 |
Moda Health Setting Facility Modifier None Typical Low $0.14 Median $0.74 Typical High $1.82 | Facility | None | $0.14 | $0.74 | $1.82 |
Moda Health Setting Professional Modifier None Typical Low $0.11 Median $0.16 Typical High $0.21 | Professional | None | $0.11 | $0.16 | $0.21 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.08 Median $0.09 Typical High $0.09 | Professional | 52 · Reduced service | $0.08 | $0.09 | $0.09 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.03 Median $0.04 Typical High $0.04 | Professional | 53 · Discontinued | $0.03 | $0.04 | $0.04 |
Molina Setting Professional Modifier None Typical Low $0.09 Median $0.09 Typical High $0.10 | Professional | None | $0.09 | $0.09 | $0.10 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $0.12 Median $0.38 Typical High $0.51 | Facility | None | $0.12 | $0.38 | $0.51 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $0.14 Median $0.33 Typical High $0.40 | Professional | None | $0.14 | $0.33 | $0.40 |
Regence BlueShield Setting Professional Modifier None Typical Low $0.12 Median $0.13 Typical High $0.14 | Professional | None | $0.12 | $0.13 | $0.14 |
Select Health Setting Facility Modifier None Typical Low $0.11 Median $0.11 Typical High $1.66 | Facility | None | $0.11 | $0.11 | $1.66 |
Select Health Setting Professional Modifier None Typical Low $0.11 Median $0.11 Typical High $0.13 | Professional | None | $0.11 | $0.11 | $0.13 |
United Setting Professional Modifier None Typical Low $0.15 Median $0.15 Typical High $0.16 | Professional | None | $0.15 | $0.15 | $0.16 |
4 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 55 · Aftercare only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $0.02 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $0.08 Median $0.08 Typical High $0.24 | Professional | 78 · Unplanned return to OR | $0.08 | $0.08 | $0.24 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.02 Median $0.03 Typical High $0.03 | Professional | 55 · Aftercare only | $0.02 | $0.03 | $0.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $0.02 |
Where Idaho sits
The same service costs 3.1 times more in Wyoming than in Texas. 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· 11th of 51
$0.14
WY $0.34TX $0.11
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.