How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $0.35 Median $0.36 Typical High $0.36 | Professional | None | $0.35 | $0.36 | $0.36 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.18 Median $0.18 Typical High $0.18 | Professional | 52 · Reduced service | $0.18 | $0.18 | $0.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 53 · Discontinued | $0.07 | $0.07 | $0.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.04 |
BCBS Idaho Setting Facility Modifier None Typical Low $0.50 Median $2.57 Typical High $3.98 | Facility | None | $0.50 | $2.57 | $3.98 |
BCBS Idaho Setting Professional Modifier None Typical Low $1.82 Median $1.82 Typical High $2.19 | Professional | None | $1.82 | $1.82 | $2.19 |
Cigna Setting Facility Modifier None Typical Low $0.40 Median $0.41 Typical High $0.98 | Facility | None | $0.40 | $0.41 | $0.98 |
Cigna Setting Professional Modifier None Typical Low $0.36 Median $0.36 Typical High $0.36 | Professional | None | $0.36 | $0.36 | $0.36 |
Moda Health Setting Facility Modifier None Typical Low $0.36 Median $0.36 Typical High $0.51 | Facility | None | $0.36 | $0.36 | $0.51 |
Moda Health Setting Professional Modifier None Typical Low $0.35 Median $0.36 Typical High $0.36 | Professional | None | $0.35 | $0.36 | $0.36 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.18 Median $0.18 Typical High $0.18 | Professional | 52 · Reduced service | $0.18 | $0.18 | $0.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 53 · Discontinued | $0.07 | $0.07 | $0.07 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.05 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.04 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Regence BlueShield Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $2.75 | Professional | None | $2.19 | $2.19 | $2.75 |
Select Health Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $2.14 | Professional | None | $1.95 | $1.95 | $2.14 |
United Setting Professional Modifier None Typical Low $0.35 Median $0.35 Typical High $0.35 | Professional | None | $0.35 | $0.35 | $0.35 |
1 more rate 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 Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1.23 Median $1.29 Typical High $1.29 | Professional | 78 · Unplanned return to OR | $1.23 | $1.29 | $1.29 |
Where Idaho sits
The same service costs 1.6 times more in Alaska than in Hawaii. 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· 8th of 51
$0.36
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.