How much rates vary
Facilitymedian $6 · 10th to 90th $4 to $10Professionalmedian $5 · 10th to 90th $3 to $30
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 $3.98 Median $5.13 Typical High $5.13 | Professional | None | $3.98 | $5.13 | $5.13 |
BCBS Idaho Setting Facility Modifier None Typical Low $4.90 Median $6.03 Typical High $10.00 | Facility | None | $4.90 | $6.03 | $10.00 |
BCBS Idaho Setting Professional Modifier None Typical Low $4.37 Median $6.61 Typical High $6.92 | Professional | None | $4.37 | $6.61 | $6.92 |
Cigna Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $3.80 | Facility | None | $3.55 | $3.55 | $3.80 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $3.55 | Professional | None | $2.95 | $2.95 | $3.55 |
Moda Health Setting Facility Modifier None Typical Low $1.82 Median $5.13 Typical High $6.31 | Facility | None | $1.82 | $5.13 | $6.31 |
Moda Health Setting Professional Modifier None Typical Low $3.98 Median $5.62 Typical High $6.61 | Professional | None | $3.98 | $5.62 | $6.61 |
Molina Setting Professional Modifier None Typical Low $4.47 Median $5.25 Typical High $30.20 | Professional | None | $4.47 | $5.25 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $5.01 Median $7.76 Typical High $371.54 | Facility | None | $5.01 | $7.76 | $371.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $6.31 Median $7.76 Typical High $436.52 | Professional | None | $6.31 | $7.76 | $436.52 |
Regence BlueShield Setting Facility Modifier None Typical Low $5.89 Median $6.03 Typical High $8.91 | Facility | None | $5.89 | $6.03 | $8.91 |
Regence BlueShield Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $6.61 | Professional | None | $4.37 | $4.37 | $6.61 |
Select Health Setting Facility Modifier None Typical Low $6.31 Median $6.31 Typical High $7.94 | Facility | None | $6.31 | $6.31 | $7.94 |
Select Health Setting Professional Modifier None Typical Low $4.07 Median $6.31 Typical High $6.76 | Professional | None | $4.07 | $6.31 | $6.76 |
United Setting Professional Modifier None Typical Low $2.57 Median $2.82 Typical High $4.27 | Professional | None | $2.57 | $2.82 | $4.27 |
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 $2.00 Median $2.57 Typical High $2.57 | Professional | 52 · Reduced service | $2.00 | $2.57 | $2.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.79 Median $1.02 Typical High $1.02 | Professional | 53 · Discontinued | $0.79 | $1.02 | $1.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.60 Median $0.78 Typical High $0.78 | Professional | 55 · Aftercare only | $0.60 | $0.78 | $0.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.40 Median $0.52 Typical High $0.52 | Professional | 56 · Pre-op care only | $0.40 | $0.52 | $0.52 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $4.07 Median $4.57 Typical High $4.79 | Professional | 78 · Unplanned return to OR | $4.07 | $4.57 | $4.79 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2.00 Median $2.57 Typical High $2.57 | Professional | 52 · Reduced service | $2.00 | $2.57 | $2.57 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.79 Median $1.02 Typical High $1.02 | Professional | 53 · Discontinued | $0.79 | $1.02 | $1.02 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.60 Median $0.78 Typical High $0.78 | Professional | 55 · Aftercare only | $0.60 | $0.78 | $0.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.40 Median $0.52 Typical High $0.52 | Professional | 56 · Pre-op care only | $0.40 | $0.52 | $0.52 |
Where Idaho sits
The same service costs 4.9 times more in Kansas than in Delaware. 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
$5.62
KS $14.45DE $2.95
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.