How much rates vary
Facilitymedian $0 · 10th to 90th $0 to $6Professionalmedian $0 · 10th to 90th $0 to $1
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 Facility Modifier None Typical Low $0.41 Median $0.41 Typical High $1.29 | Facility | None | $0.41 | $0.41 | $1.29 |
Aetna Setting Professional Modifier None Typical Low $0.34 Median $0.35 Typical High $0.35 | Professional | None | $0.34 | $0.35 | $0.35 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.17 Median $0.18 Typical High $0.18 | Professional | 52 · Reduced service | $0.17 | $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 $0.03 Median $0.04 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.03 | $0.04 | $0.04 |
BCBS Idaho Setting Facility Modifier None Typical Low $0.05 Median $0.06 Typical High $2.51 | Facility | None | $0.05 | $0.06 | $2.51 |
BCBS Idaho Setting Professional Modifier None Typical Low $0.50 Median $0.50 Typical High $0.50 | Professional | None | $0.50 | $0.50 | $0.50 |
Cigna Setting Facility Modifier None Typical Low $0.39 Median $0.40 Typical High $0.95 | Facility | None | $0.39 | $0.40 | $0.95 |
Cigna Setting Professional Modifier None Typical Low $0.35 Median $0.35 Typical High $0.35 | Professional | None | $0.35 | $0.35 | $0.35 |
Moda Health Setting Facility Modifier None Typical Low $0.35 Median $0.50 Typical High $6.17 | Facility | None | $0.35 | $0.50 | $6.17 |
Moda Health Setting Professional Modifier None Typical Low $0.34 Median $0.35 Typical High $0.35 | Professional | None | $0.34 | $0.35 | $0.35 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.17 Median $0.18 Typical High $0.18 | Professional | 52 · Reduced service | $0.17 | $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 $0.03 Median $0.04 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.03 | $0.04 | $0.04 |
Molina Setting Professional Modifier None Typical Low $0.27 Median $0.32 Typical High $30.20 | Professional | None | $0.27 | $0.32 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $0.34 Median $0.38 Typical High $0.55 | Facility | None | $0.34 | $0.38 | $0.55 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $0.34 Median $0.38 Typical High $0.65 | Professional | None | $0.34 | $0.38 | $0.65 |
Regence BlueShield Setting Professional Modifier None Typical Low $0.50 Median $0.50 Typical High $0.63 | Professional | None | $0.50 | $0.50 | $0.63 |
Select Health Setting Facility Modifier None Typical Low $0.17 Median $0.20 Typical High $2.88 | Facility | None | $0.17 | $0.20 | $2.88 |
Select Health Setting Professional Modifier None Typical Low $0.23 Median $0.52 Typical High $0.59 | Professional | None | $0.23 | $0.52 | $0.59 |
United Setting Professional Modifier None Typical Low $0.34 Median $0.34 Typical High $0.34 | Professional | None | $0.34 | $0.34 | $0.34 |
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 $0.33 Median $0.35 Typical High $0.35 | Professional | 78 · Unplanned return to OR | $0.33 | $0.35 | $0.35 |
Where Idaho sits
The same service costs 1.6 times more in Montana than in Michigan. 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· 32nd of 51
$0.35
MT $0.52MI $0.33
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.