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 $1.70 Median $2.82 Typical High $2.82 | Professional | None | $1.70 | $2.82 | $2.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.26 Median $0.42 Typical High $0.42 | Professional | 55 · Aftercare only | $0.26 | $0.42 | $0.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.17 Median $0.28 Typical High $0.28 | Professional | 56 · Pre-op care only | $0.17 | $0.28 | $0.28 |
BCBS Idaho Setting Facility Modifier None Typical Low $2.34 Median $2.82 Typical High $3.63 | Facility | None | $2.34 | $2.82 | $3.63 |
BCBS Idaho Setting Professional Modifier None Typical Low $2.40 Median $2.40 Typical High $2.40 | Professional | None | $2.40 | $2.40 | $2.40 |
Cigna Setting Professional Modifier None Typical Low $0.87 Median $0.87 Typical High $1.70 | Professional | None | $0.87 | $0.87 | $1.70 |
Moda Health Setting Facility Modifier None Typical Low $1.70 Median $2.82 Typical High $4.07 | Facility | None | $1.70 | $2.82 | $4.07 |
Moda Health Setting Professional Modifier None Typical Low $1.70 Median $2.82 Typical High $2.82 | Professional | None | $1.70 | $2.82 | $2.82 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.26 Median $0.42 Typical High $0.42 | Professional | 55 · Aftercare only | $0.26 | $0.42 | $0.42 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.17 Median $0.28 Typical High $0.28 | Professional | 56 · Pre-op care only | $0.17 | $0.28 | $0.28 |
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 $2.19 Median $2.19 Typical High $4.57 | Professional | None | $2.19 | $2.19 | $4.57 |
Select Health Setting Facility Modifier None Typical Low $2.69 Median $3.16 Typical High $4.47 | Facility | None | $2.69 | $3.16 | $4.47 |
United Setting Professional Modifier None Typical Low $0.87 Median $1.29 Typical High $2.04 | Professional | None | $0.87 | $1.29 | $2.04 |
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 $1.41 Median $1.58 Typical High $1.66 | Professional | 78 · Unplanned return to OR | $1.41 | $1.58 | $1.66 |
Where Idaho sits
The same service costs 6.6 times more in Kentucky than in West Virginia. 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· 17th of 51
$2.04
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.