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 $12.59 Median $25.70 Typical High $25.70 | Professional | None | $12.59 | $25.70 | $25.70 |
BCBS Idaho Setting Facility Modifier None Typical Low $12.02 Median $18.20 Typical High $30.90 | Facility | None | $12.02 | $18.20 | $30.90 |
BCBS Idaho Setting Professional Modifier None Typical Low $13.49 Median $20.42 Typical High $21.38 | Professional | None | $13.49 | $20.42 | $21.38 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $12.59 Median $14.13 Typical High $14.79 | Professional | 78 · Unplanned return to OR | $12.59 | $14.13 | $14.79 |
Cigna Setting Facility Modifier None Typical Low $13.49 Median $13.49 Typical High $14.45 | Facility | None | $13.49 | $13.49 | $14.45 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $13.49 | Professional | None | $11.48 | $11.48 | $13.49 |
Moda Health Setting Facility Modifier None Typical Low $6.17 Median $18.62 Typical High $25.70 | Facility | None | $6.17 | $18.62 | $25.70 |
Moda Health Setting Professional Modifier None Typical Low $15.85 Median $20.42 Typical High $25.70 | Professional | None | $15.85 | $20.42 | $25.70 |
Molina Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | None | $13.49 | $13.49 | $13.49 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $15.49 Median $23.99 Typical High $1,174.90 | Facility | None | $15.49 | $23.99 | $1,174.90 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $20.42 Median $23.99 Typical High $1,380.38 | Professional | None | $20.42 | $23.99 | $1,380.38 |
Regence BlueShield Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $20.42 | Professional | None | $13.49 | $13.49 | $20.42 |
Select Health Setting Facility Modifier None Typical Low $19.50 Median $19.50 Typical High $25.12 | Facility | None | $19.50 | $19.50 | $25.12 |
Select Health Setting Professional Modifier None Typical Low $12.59 Median $19.50 Typical High $21.38 | Professional | None | $12.59 | $19.50 | $21.38 |
United Setting Professional Modifier None Typical Low $8.71 Median $9.55 Typical High $14.79 | Professional | None | $8.71 | $9.55 | $14.79 |
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 $1.91 Median $3.89 Typical High $3.89 | Professional | 55 · Aftercare only | $1.91 | $3.89 | $3.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.26 Median $2.57 Typical High $2.57 | Professional | 56 · Pre-op care only | $1.26 | $2.57 | $2.57 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.91 Median $3.89 Typical High $3.89 | Professional | 55 · Aftercare only | $1.91 | $3.89 | $3.89 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.26 Median $2.57 Typical High $2.57 | Professional | 56 · Pre-op care only | $1.26 | $2.57 | $2.57 |
Where Idaho sits
The same service costs 2.8 times more in Hawaii 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· 7th of 51
$20.42
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.