How much rates vary
Facilitymedian $2 · 10th to 90th $2 to $9Professionalmedian $2 · 10th to 90th $2 to $2
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 $2.82 Median $2.82 Typical High $2.82 | Facility | None | $2.82 | $2.82 | $2.82 |
Aetna Setting Professional Modifier None Typical Low $1.91 Median $2.34 Typical High $2.34 | Professional | None | $1.91 | $2.34 | $2.34 |
BCBS Idaho Setting Facility Modifier None Typical Low $2.95 Median $5.62 Typical High $10.72 | Facility | None | $2.95 | $5.62 | $10.72 |
BCBS Idaho Setting Professional Modifier None Typical Low $2.04 Median $2.24 Typical High $8.71 | Professional | None | $2.04 | $2.24 | $8.71 |
Cigna Setting Facility Modifier None Typical Low $2.04 Median $2.09 Typical High $4.79 | Facility | None | $2.04 | $2.09 | $4.79 |
Cigna Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | None | $1.86 | $1.86 | $1.86 |
Moda Health Setting Facility Modifier None Typical Low $1.86 Median $2.34 Typical High $9.33 | Facility | None | $1.86 | $2.34 | $9.33 |
Moda Health Setting Professional Modifier None Typical Low $1.82 Median $2.04 Typical High $2.34 | Professional | None | $1.82 | $2.04 | $2.34 |
Molina Setting Professional Modifier None Typical Low $1.35 Median $1.35 Typical High $1.58 | Professional | None | $1.35 | $1.35 | $1.58 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $1.91 Median $2.04 Typical High $2.51 | Facility | None | $1.91 | $2.04 | $2.51 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1.91 Median $2.04 Typical High $2.34 | Professional | None | $1.91 | $2.04 | $2.34 |
Regence BlueShield Setting Professional Modifier None Typical Low $1.86 Median $2.24 Typical High $2.34 | Professional | None | $1.86 | $2.24 | $2.34 |
Select Health Setting Facility Modifier None Typical Low $1.86 Median $1.86 Typical High $3.89 | Facility | None | $1.86 | $1.86 | $3.89 |
Select Health Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $1.95 | Professional | None | $1.86 | $1.86 | $1.95 |
United Setting Professional Modifier None Typical Low $1.66 Median $1.66 Typical High $1.66 | Professional | None | $1.66 | $1.66 | $1.66 |
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 $0.95 Median $1.17 Typical High $1.17 | Professional | 52 · Reduced service | $0.95 | $1.17 | $1.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.38 Median $0.47 Typical High $0.47 | Professional | 53 · Discontinued | $0.38 | $0.47 | $0.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.28 Median $0.35 Typical High $0.35 | Professional | 55 · Aftercare only | $0.28 | $0.35 | $0.35 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.19 Median $0.23 Typical High $0.23 | Professional | 56 · Pre-op care only | $0.19 | $0.23 | $0.23 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1.38 Median $1.45 Typical High $6.03 | Professional | 78 · Unplanned return to OR | $1.38 | $1.45 | $6.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.89 Median $1.02 Typical High $1.02 | Professional | 52 · Reduced service | $0.89 | $1.02 | $1.02 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.36 Median $0.41 Typical High $0.41 | Professional | 53 · Discontinued | $0.36 | $0.41 | $0.41 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.27 Median $0.31 Typical High $0.31 | Professional | 55 · Aftercare only | $0.27 | $0.31 | $0.31 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.18 Median $0.21 Typical High $0.21 | Professional | 56 · Pre-op care only | $0.18 | $0.21 | $0.21 |
Where Idaho sits
Rates are fairly even across states for this service. 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· 4th of 51
$2.04
AK $2.29MD $1.66
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.