How much rates vary
Facilitymedian $9 · 10th to 90th $6 to $22Professionalmedian $6 · 10th to 90th $5 to $7
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 $7.76 Median $7.76 Typical High $7.76 | Facility | None | $7.76 | $7.76 | $7.76 |
Aetna Setting Professional Modifier None Typical Low $5.25 Median $6.61 Typical High $6.61 | Professional | None | $5.25 | $6.61 | $6.61 |
BCBS Idaho Setting Facility Modifier None Typical Low $8.51 Median $11.75 Typical High $25.12 | Facility | None | $8.51 | $11.75 | $25.12 |
BCBS Idaho Setting Professional Modifier None Typical Low $5.75 Median $5.89 Typical High $38.02 | Professional | None | $5.75 | $5.89 | $38.02 |
Cigna Setting Facility Modifier None Typical Low $7.41 Median $7.41 Typical High $13.49 | Facility | None | $7.41 | $7.41 | $13.49 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | None | $5.25 | $5.25 | $5.25 |
Moda Health Setting Facility Modifier None Typical Low $5.37 Median $6.61 Typical High $9.12 | Facility | None | $5.37 | $6.61 | $9.12 |
Moda Health Setting Professional Modifier None Typical Low $5.25 Median $6.17 Typical High $6.61 | Professional | None | $5.25 | $6.17 | $6.61 |
Molina Setting Professional Modifier None Typical Low $4.90 Median $5.75 Typical High $5.75 | Professional | None | $4.90 | $5.75 | $5.75 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $5.75 Median $5.75 Typical High $7.59 | Facility | None | $5.75 | $5.75 | $7.59 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $4.90 Median $6.03 Typical High $6.61 | Professional | None | $4.90 | $6.03 | $6.61 |
Regence BlueShield Setting Facility Modifier None Typical Low $9.55 Median $13.18 Typical High $34.67 | Facility | None | $9.55 | $13.18 | $34.67 |
Regence BlueShield Setting Professional Modifier None Typical Low $5.75 Median $6.31 Typical High $6.61 | Professional | None | $5.75 | $6.31 | $6.61 |
Select Health Setting Facility Modifier None Typical Low $5.25 Median $5.25 Typical High $10.96 | Facility | None | $5.25 | $5.25 | $10.96 |
Select Health Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $5.50 | Professional | None | $5.25 | $5.25 | $5.50 |
United Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $5.25 | Professional | None | $4.90 | $4.90 | $5.25 |
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 $2.69 Median $3.31 Typical High $3.31 | Professional | 52 · Reduced service | $2.69 | $3.31 | $3.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.07 Median $1.32 Typical High $1.32 | Professional | 53 · Discontinued | $1.07 | $1.32 | $1.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.79 Median $1.00 Typical High $1.00 | Professional | 55 · Aftercare only | $0.79 | $1.00 | $1.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.66 Typical High $0.66 | Professional | 56 · Pre-op care only | $0.52 | $0.66 | $0.66 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3.89 Median $4.07 Typical High $25.70 | Professional | 78 · Unplanned return to OR | $3.89 | $4.07 | $25.70 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2.69 Median $3.09 Typical High $3.09 | Professional | 52 · Reduced service | $2.69 | $3.09 | $3.09 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.07 Median $1.23 Typical High $1.23 | Professional | 53 · Discontinued | $1.07 | $1.23 | $1.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.81 Median $0.93 Typical High $0.93 | Professional | 55 · Aftercare only | $0.81 | $0.93 | $0.93 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.54 Median $0.62 Typical High $0.62 | Professional | 56 · Pre-op care only | $0.54 | $0.62 | $0.62 |
Where Idaho sits
The same service costs 1.9 times more in Wyoming than in Colorado. 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· 6th of 51
$5.89
WY $10.00CO $5.25
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.