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 $25.12 Median $60.26 Typical High $60.26 | Professional | None | $25.12 | $60.26 | $60.26 |
BCBS Idaho Setting Facility Modifier None Typical Low $32.36 Median $42.66 Typical High $72.44 | Facility | None | $32.36 | $42.66 | $72.44 |
BCBS Idaho Setting Professional Modifier None Typical Low $31.62 Median $47.86 Typical High $50.12 | Professional | None | $31.62 | $47.86 | $50.12 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $29.51 Median $33.11 Typical High $34.67 | Professional | 78 · Unplanned return to OR | $29.51 | $33.11 | $34.67 |
Cigna Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $28.18 | Facility | None | $26.92 | $26.92 | $28.18 |
Cigna Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $26.92 | Professional | None | $22.91 | $22.91 | $26.92 |
Moda Health Setting Facility Modifier None Typical Low $12.02 Median $42.66 Typical High $60.26 | Facility | None | $12.02 | $42.66 | $60.26 |
Moda Health Setting Professional Modifier None Typical Low $32.36 Median $47.86 Typical High $60.26 | Professional | None | $32.36 | $47.86 | $60.26 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $30.20 Median $56.23 Typical High $2,691.53 | Facility | None | $30.20 | $56.23 | $2,691.53 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $45.71 Median $56.23 Typical High $3,162.28 | Professional | None | $45.71 | $56.23 | $3,162.28 |
Regence BlueShield Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $47.86 | Professional | None | $31.62 | $31.62 | $47.86 |
Select Health Setting Facility Modifier None Typical Low $41.69 Median $45.71 Typical High $57.54 | Facility | None | $41.69 | $45.71 | $57.54 |
Select Health Setting Professional Modifier None Typical Low $29.51 Median $45.71 Typical High $48.98 | Professional | None | $29.51 | $45.71 | $48.98 |
United Setting Professional Modifier None Typical Low $17.38 Median $18.62 Typical High $30.20 | Professional | None | $17.38 | $18.62 | $30.20 |
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 $3.80 Median $9.12 Typical High $9.12 | Professional | 55 · Aftercare only | $3.80 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $6.03 Typical High $6.03 | Professional | 56 · Pre-op care only | $2.51 | $6.03 | $6.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $9.12 Typical High $9.12 | Professional | 55 · Aftercare only | $3.80 | $9.12 | $9.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $6.03 Typical High $6.03 | Professional | 56 · Pre-op care only | $2.51 | $6.03 | $6.03 |
Where Idaho sits
The same service costs 2.5 times more in Idaho than in Kentucky. 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
$46.77
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.