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 $5.62 Median $13.18 Typical High $13.18 | Professional | None | $5.62 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.85 Median $1.95 Typical High $1.95 | Professional | 55 · Aftercare only | $0.85 | $1.95 | $1.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.56 Median $1.32 Typical High $1.32 | Professional | 56 · Pre-op care only | $0.56 | $1.32 | $1.32 |
BCBS Idaho Setting Facility Modifier None Typical Low $7.08 Median $9.12 Typical High $15.49 | Facility | None | $7.08 | $9.12 | $15.49 |
BCBS Idaho Setting Professional Modifier None Typical Low $6.92 Median $10.47 Typical High $10.96 | Professional | None | $6.92 | $10.47 | $10.96 |
Cigna Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | None | $5.13 | $5.13 | $5.13 |
Moda Health Setting Facility Modifier None Typical Low $5.62 Median $13.18 Typical High $18.62 | Facility | None | $5.62 | $13.18 | $18.62 |
Moda Health Setting Professional Modifier None Typical Low $5.62 Median $10.47 Typical High $13.18 | Professional | None | $5.62 | $10.47 | $13.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.85 Median $1.95 Typical High $1.95 | Professional | 55 · Aftercare only | $0.85 | $1.95 | $1.95 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.58 Median $1.32 Typical High $1.32 | Professional | 56 · Pre-op care only | $0.58 | $1.32 | $1.32 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $12.30 Median $363.08 Typical High $588.84 | Facility | None | $12.30 | $363.08 | $588.84 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $10.47 Median $12.30 Typical High $691.83 | Professional | None | $10.47 | $12.30 | $691.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $10.47 | Professional | None | $6.92 | $6.92 | $10.47 |
Select Health Setting Facility Modifier None Typical Low $9.12 Median $9.77 Typical High $12.59 | Facility | None | $9.12 | $9.77 | $12.59 |
Select Health Setting Professional Modifier None Typical Low $9.77 Median $10.72 Typical High $22.91 | Professional | None | $9.77 | $10.72 | $22.91 |
United Setting Professional Modifier None Typical Low $3.31 Median $4.27 Typical High $6.46 | Professional | None | $3.31 | $4.27 | $6.46 |
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 $6.46 Median $7.24 Typical High $7.59 | Professional | 78 · Unplanned return to OR | $6.46 | $7.24 | $7.59 |
Where Idaho sits
The same service costs 2.7 times more in Hawaii than in Colorado. 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· 2nd of 51
$10.47
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.