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 $0.12 Median $0.13 Typical High $0.13 | Professional | None | $0.12 | $0.13 | $0.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.06 Median $0.07 Typical High $0.07 | Professional | 52 · Reduced service | $0.06 | $0.07 | $0.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.02 Median $0.03 Typical High $0.03 | Professional | 53 · Discontinued | $0.02 | $0.03 | $0.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $0.02 |
BCBS Idaho Setting Facility Modifier None Typical Low $0.04 Median $0.10 Typical High $0.41 | Facility | None | $0.04 | $0.10 | $0.41 |
BCBS Idaho Setting Professional Modifier None Typical Low $0.26 Median $0.26 Typical High $0.49 | Professional | None | $0.26 | $0.26 | $0.49 |
Cigna Setting Facility Modifier None Typical Low $0.14 Median $0.15 Typical High $0.35 | Facility | None | $0.14 | $0.15 | $0.35 |
Cigna Setting Professional Modifier None Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | None | $0.13 | $0.13 | $0.13 |
Moda Health Setting Facility Modifier None Typical Low $0.13 Median $0.13 Typical High $7.41 | Facility | None | $0.13 | $0.13 | $7.41 |
Moda Health Setting Professional Modifier None Typical Low $0.12 Median $0.13 Typical High $0.13 | Professional | None | $0.12 | $0.13 | $0.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.06 Median $0.07 Typical High $0.07 | Professional | 52 · Reduced service | $0.06 | $0.07 | $0.07 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.02 Median $0.03 Typical High $0.03 | Professional | 53 · Discontinued | $0.02 | $0.03 | $0.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $0.02 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $2.04 Median $2.29 Typical High $3.31 | Facility | None | $2.04 | $2.29 | $3.31 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2.04 Median $2.29 Typical High $3.89 | Professional | None | $2.04 | $2.29 | $3.89 |
Regence BlueShield Setting Professional Modifier None Typical Low $0.49 Median $0.49 Typical High $0.62 | Professional | None | $0.49 | $0.49 | $0.62 |
Select Health Setting Facility Modifier None Typical Low $0.17 Median $0.20 Typical High $0.28 | Facility | None | $0.17 | $0.20 | $0.28 |
Select Health Setting Professional Modifier None Typical Low $0.11 Median $0.27 Typical High $0.30 | Professional | None | $0.11 | $0.27 | $0.30 |
United Setting Professional Modifier None Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | None | $0.13 | $0.13 | $0.13 |
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 $0.17 Median $0.18 Typical High $0.18 | Professional | 78 · Unplanned return to OR | $0.17 | $0.18 | $0.18 |
Where Idaho sits
The same service costs 32.4 times more in Montana 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· 3rd of 51
$0.26
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.