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 $1.74 Median $4.17 Typical High $4.17 | Professional | None | $1.74 | $4.17 | $4.17 |
BCBS Idaho Setting Facility Modifier None Typical Low $2.24 Median $3.02 Typical High $5.13 | Facility | None | $2.24 | $3.02 | $5.13 |
BCBS Idaho Setting Professional Modifier None Typical Low $2.19 Median $3.31 Typical High $3.47 | Professional | None | $2.19 | $3.31 | $3.47 |
Cigna Setting Facility Modifier None Typical Low $1.86 Median $1.86 Typical High $2.00 | Facility | None | $1.86 | $1.86 | $2.00 |
Cigna Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $1.86 | Professional | None | $1.58 | $1.58 | $1.86 |
Moda Health Setting Facility Modifier None Typical Low $0.83 Median $3.02 Typical High $4.17 | Facility | None | $0.83 | $3.02 | $4.17 |
Moda Health Setting Professional Modifier None Typical Low $2.29 Median $3.31 Typical High $4.17 | Professional | None | $2.29 | $3.31 | $4.17 |
Molina Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $30.20 | Professional | None | $2.19 | $2.19 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $2.51 Median $3.98 Typical High $190.55 | Facility | None | $2.51 | $3.98 | $190.55 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $3.16 Median $3.98 Typical High $223.87 | Professional | None | $3.16 | $3.98 | $223.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $3.31 | Professional | None | $2.19 | $2.19 | $3.31 |
Select Health Setting Facility Modifier None Typical Low $3.16 Median $3.16 Typical High $3.98 | Facility | None | $3.16 | $3.16 | $3.98 |
Select Health Setting Professional Modifier None Typical Low $2.04 Median $3.16 Typical High $3.47 | Professional | None | $2.04 | $3.16 | $3.47 |
United Setting Professional Modifier None Typical Low $1.20 Median $1.32 Typical High $2.14 | Professional | None | $1.20 | $1.32 | $2.14 |
5 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 $0.26 Median $0.63 Typical High $0.63 | Professional | 55 · Aftercare only | $0.26 | $0.63 | $0.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.18 Median $0.42 Typical High $0.42 | Professional | 56 · Pre-op care only | $0.18 | $0.42 | $0.42 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2.04 Median $2.29 Typical High $2.45 | Professional | 78 · Unplanned return to OR | $2.04 | $2.29 | $2.45 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.26 Median $0.63 Typical High $0.63 | Professional | 55 · Aftercare only | $0.26 | $0.63 | $0.63 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.18 Median $0.42 Typical High $0.42 | Professional | 56 · Pre-op care only | $0.18 | $0.42 | $0.42 |
Where Idaho sits
The same service costs 3.0 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· 3rd of 51
$3.31
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.