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 $19.95 Median $40.74 Typical High $40.74 | Professional | None | $19.95 | $40.74 | $40.74 |
BCBS Idaho Setting Facility Modifier None Typical Low $19.50 Median $28.84 Typical High $48.98 | Facility | None | $19.50 | $28.84 | $48.98 |
BCBS Idaho Setting Professional Modifier None Typical Low $21.38 Median $32.36 Typical High $33.88 | Professional | None | $21.38 | $32.36 | $33.88 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $19.95 Median $22.39 Typical High $23.44 | Professional | 78 · Unplanned return to OR | $19.95 | $22.39 | $23.44 |
Cigna Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $22.39 | Facility | None | $21.38 | $21.38 | $22.39 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $21.38 | Professional | None | $18.20 | $18.20 | $21.38 |
Moda Health Setting Facility Modifier None Typical Low $9.77 Median $30.90 Typical High $40.74 | Facility | None | $9.77 | $30.90 | $40.74 |
Moda Health Setting Professional Modifier None Typical Low $22.91 Median $32.36 Typical High $40.74 | Professional | None | $22.91 | $32.36 | $40.74 |
Molina Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $24.55 Median $38.02 Typical High $1,819.70 | Facility | None | $24.55 | $38.02 | $1,819.70 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $30.90 Median $38.02 Typical High $2,137.96 | Professional | None | $30.90 | $38.02 | $2,137.96 |
Regence BlueShield Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $32.36 | Professional | None | $21.38 | $21.38 | $32.36 |
Select Health Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $43.65 | Facility | None | $30.90 | $30.90 | $43.65 |
Select Health Setting Professional Modifier None Typical Low $19.95 Median $30.90 Typical High $33.88 | Professional | None | $19.95 | $30.90 | $33.88 |
United Setting Professional Modifier None Typical Low $13.80 Median $15.14 Typical High $23.44 | Professional | None | $13.80 | $15.14 | $23.44 |
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 $3.02 Median $6.17 Typical High $6.17 | Professional | 55 · Aftercare only | $3.02 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.00 Median $4.07 Typical High $4.07 | Professional | 56 · Pre-op care only | $2.00 | $4.07 | $4.07 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $6.17 Typical High $6.17 | Professional | 55 · Aftercare only | $3.02 | $6.17 | $6.17 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.00 Median $4.07 Typical High $4.07 | Professional | 56 · Pre-op care only | $2.00 | $4.07 | $4.07 |
Where Idaho sits
The same service costs 2.6 times more in Hawaii than in New Hampshire. 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· 10th of 51
$32.36
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.