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 $3.89 Median $9.33 Typical High $9.33 | Professional | None | $3.89 | $9.33 | $9.33 |
BCBS Idaho Setting Facility Modifier None Typical Low $5.01 Median $6.61 Typical High $11.22 | Facility | None | $5.01 | $6.61 | $11.22 |
BCBS Idaho Setting Professional Modifier None Typical Low $4.90 Median $7.41 Typical High $7.76 | Professional | None | $4.90 | $7.41 | $7.76 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $4.57 Median $5.13 Typical High $5.37 | Professional | 78 · Unplanned return to OR | $4.57 | $5.13 | $5.37 |
Cigna Setting Facility Modifier None Typical Low $4.17 Median $4.17 Typical High $4.47 | Facility | None | $4.17 | $4.17 | $4.47 |
Cigna Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $4.17 | Professional | None | $3.55 | $3.55 | $4.17 |
Moda Health Setting Facility Modifier None Typical Low $1.91 Median $6.61 Typical High $9.33 | Facility | None | $1.91 | $6.61 | $9.33 |
Moda Health Setting Professional Modifier None Typical Low $5.01 Median $7.41 Typical High $9.33 | Professional | None | $5.01 | $7.41 | $9.33 |
Molina Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $30.20 | Professional | None | $4.90 | $4.90 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $5.50 Median $8.71 Typical High $416.87 | Facility | None | $5.50 | $8.71 | $416.87 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $7.08 Median $8.71 Typical High $489.78 | Professional | None | $7.08 | $8.71 | $489.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $7.41 | Professional | None | $4.90 | $4.90 | $7.41 |
Select Health Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $9.12 | Facility | None | $7.08 | $7.08 | $9.12 |
Select Health Setting Professional Modifier None Typical Low $4.57 Median $7.08 Typical High $7.59 | Professional | None | $4.57 | $7.08 | $7.59 |
United Setting Professional Modifier None Typical Low $2.69 Median $2.95 Typical High $4.79 | Professional | None | $2.69 | $2.95 | $4.79 |
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 $0.59 Median $1.41 Typical High $1.41 | Professional | 55 · Aftercare only | $0.59 | $1.41 | $1.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.39 Median $0.93 Typical High $0.93 | Professional | 56 · Pre-op care only | $0.39 | $0.93 | $0.93 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.59 Median $1.41 Typical High $1.41 | Professional | 55 · Aftercare only | $0.59 | $1.41 | $1.41 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.39 Median $0.93 Typical High $0.93 | Professional | 56 · Pre-op care only | $0.39 | $0.93 | $0.93 |
Where Idaho sits
The same service costs 2.1 times more in Idaho 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· 1st of 51
$7.24
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.