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 $33.88 Median $63.10 Typical High $66.07 | Professional | None | $33.88 | $63.10 | $66.07 |
BCBS Idaho Setting Facility Modifier None Typical Low $83.18 Median $117.49 Typical High $131.83 | Facility | None | $83.18 | $117.49 | $131.83 |
BCBS Idaho Setting Professional Modifier None Typical Low $53.70 Median $61.66 Typical High $77.62 | Professional | None | $53.70 | $61.66 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $79.43 Typical High $95.50 | Professional | None | $60.26 | $79.43 | $95.50 |
Moda Health Setting Facility Modifier None Typical Low $58.88 Median $66.07 Typical High $95.50 | Facility | None | $58.88 | $66.07 | $95.50 |
Moda Health Setting Professional Modifier None Typical Low $53.70 Median $66.07 Typical High $75.86 | Professional | None | $53.70 | $66.07 | $75.86 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $70.79 | Facility | None | $58.88 | $58.88 | $70.79 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $58.88 Median $60.26 Typical High $70.79 | Professional | None | $58.88 | $60.26 | $70.79 |
Regence BlueShield Setting Professional Modifier None Typical Low $53.70 Median $56.23 Typical High $75.86 | Professional | None | $53.70 | $56.23 | $75.86 |
Select Health Setting Facility Modifier None Typical Low $37.15 Median $38.02 Typical High $131.83 | Facility | None | $37.15 | $38.02 | $131.83 |
Select Health Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $61.66 | Professional | None | $37.15 | $37.15 | $61.66 |
United Setting Professional Modifier None Typical Low $45.71 Median $69.18 Typical High $97.72 | Professional | None | $45.71 | $69.18 | $97.72 |
7 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 $15.85 Median $33.11 Typical High $33.11 | Professional | 52 · Reduced service | $15.85 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $10.00 Typical High $10.00 | Professional | 55 · Aftercare only | $4.79 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $6.61 Typical High $6.61 | Professional | 56 · Pre-op care only | $3.24 | $6.61 | $6.61 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $38.90 Median $44.67 Typical High $52.48 | Professional | 78 · Unplanned return to OR | $38.90 | $44.67 | $52.48 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $19.50 Median $33.11 Typical High $33.11 | Professional | 52 · Reduced service | $19.50 | $33.11 | $33.11 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $10.00 Typical High $10.00 | Professional | 55 · Aftercare only | $5.89 | $10.00 | $10.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $6.61 Typical High $6.61 | Professional | 56 · Pre-op care only | $3.89 | $6.61 | $6.61 |
Where Idaho sits
The same service costs 2.6 times more in Nebraska than in Texas. 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· 9th of 51
$64.57
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.