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 $13.49 Median $28.84 Typical High $28.84 | Professional | None | $13.49 | $28.84 | $28.84 |
BCBS Idaho Setting Facility Modifier None Typical Low $15.49 Median $20.42 Typical High $34.67 | Facility | None | $15.49 | $20.42 | $34.67 |
BCBS Idaho Setting Professional Modifier None Typical Low $15.14 Median $22.91 Typical High $23.99 | Professional | None | $15.14 | $22.91 | $23.99 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $14.45 Median $16.22 Typical High $16.98 | Professional | 78 · Unplanned return to OR | $14.45 | $16.22 | $16.98 |
Cigna Setting Facility Modifier None Typical Low $15.14 Median $15.14 Typical High $16.22 | Facility | None | $15.14 | $15.14 | $16.22 |
Cigna Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $15.14 | Professional | None | $12.88 | $12.88 | $15.14 |
Moda Health Setting Facility Modifier None Typical Low $6.92 Median $21.88 Typical High $28.84 | Facility | None | $6.92 | $21.88 | $28.84 |
Moda Health Setting Professional Modifier None Typical Low $15.85 Median $22.91 Typical High $28.84 | Professional | None | $15.85 | $22.91 | $28.84 |
Molina Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $17.38 Median $27.54 Typical High $1,318.26 | Facility | None | $17.38 | $27.54 | $1,318.26 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $22.91 Median $27.54 Typical High $1,548.82 | Professional | None | $22.91 | $27.54 | $1,548.82 |
Regence BlueShield Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $22.91 | Professional | None | $15.14 | $15.14 | $22.91 |
Select Health Setting Facility Modifier None Typical Low $21.88 Median $21.88 Typical High $28.18 | Facility | None | $21.88 | $21.88 | $28.18 |
Select Health Setting Professional Modifier None Typical Low $14.13 Median $21.88 Typical High $23.99 | Professional | None | $14.13 | $21.88 | $23.99 |
United Setting Professional Modifier None Typical Low $9.77 Median $10.72 Typical High $16.60 | Professional | None | $9.77 | $10.72 | $16.60 |
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 $2.04 Median $4.37 Typical High $4.37 | Professional | 55 · Aftercare only | $2.04 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.35 Median $2.88 Typical High $2.88 | Professional | 56 · Pre-op care only | $1.35 | $2.88 | $2.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.04 Median $4.37 Typical High $4.37 | Professional | 55 · Aftercare only | $2.04 | $4.37 | $4.37 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.35 Median $2.88 Typical High $2.88 | Professional | 56 · Pre-op care only | $1.35 | $2.88 | $2.88 |
Where Idaho sits
The same service costs 3.5 times more in Hawaii than in Connecticut. 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· 7th of 51
$22.91
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.