How much rates vary
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 Professional Modifier None Typical Low $11.75 Median $23.99 Typical High $23.99 | Professional | None | $11.75 | $23.99 | $23.99 |
BCBS Idaho Setting Facility Modifier None Typical Low $11.22 Median $16.60 Typical High $28.84 | Facility | None | $11.22 | $16.60 | $28.84 |
BCBS Idaho Setting Professional Modifier None Typical Low $12.59 Median $19.05 Typical High $19.95 | Professional | None | $12.59 | $19.05 | $19.95 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $11.75 Median $13.18 Typical High $13.80 | Professional | 78 · Unplanned return to OR | $11.75 | $13.18 | $13.80 |
Cigna Setting Facility Modifier None Typical Low $12.30 Median $12.30 Typical High $13.18 | Facility | None | $12.30 | $12.30 | $13.18 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $12.30 | Professional | None | $10.47 | $10.47 | $12.30 |
Moda Health Setting Facility Modifier None Typical Low $5.62 Median $17.78 Typical High $23.99 | Facility | None | $5.62 | $17.78 | $23.99 |
Moda Health Setting Professional Modifier None Typical Low $12.88 Median $19.05 Typical High $23.99 | Professional | None | $12.88 | $19.05 | $23.99 |
Molina Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | None | $12.59 | $12.59 | $12.59 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $14.45 Median $22.39 Typical High $1,071.52 | Facility | None | $14.45 | $22.39 | $1,071.52 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $19.05 Median $22.39 Typical High $1,258.93 | Professional | None | $19.05 | $22.39 | $1,258.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $19.05 | Professional | None | $12.59 | $12.59 | $19.05 |
Select Health Setting Facility Modifier None Typical Low $17.78 Median $17.78 Typical High $22.91 | Facility | None | $17.78 | $17.78 | $22.91 |
Select Health Setting Professional Modifier None Typical Low $11.75 Median $17.78 Typical High $19.50 | Professional | None | $11.75 | $17.78 | $19.50 |
United Setting Professional Modifier None Typical Low $8.13 Median $8.71 Typical High $13.80 | Professional | None | $8.13 | $8.71 | $13.80 |
4 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 55 · Aftercare only Typical Low $1.78 Median $3.55 Typical High $3.55 | Professional | 55 · Aftercare only | $1.78 | $3.55 | $3.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.17 Median $2.40 Typical High $2.40 | Professional | 56 · Pre-op care only | $1.17 | $2.40 | $2.40 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.78 Median $3.55 Typical High $3.55 | Professional | 55 · Aftercare only | $1.78 | $3.55 | $3.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.17 Median $2.40 Typical High $2.40 | Professional | 56 · Pre-op care only | $1.17 | $2.40 | $2.40 |
Where Idaho sits
The same service costs 3.0 times more in Hawaii than in Rhode Island. 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· 8th of 51
$18.62
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.