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 $5.13 Median $12.30 Typical High $12.30 | Professional | None | $5.13 | $12.30 | $12.30 |
BCBS Idaho Setting Facility Modifier None Typical Low $6.61 Median $8.71 Typical High $14.45 | Facility | None | $6.61 | $8.71 | $14.45 |
BCBS Idaho Setting Professional Modifier None Typical Low $6.46 Median $9.55 Typical High $10.00 | Professional | None | $6.46 | $9.55 | $10.00 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $6.03 Median $6.76 Typical High $7.08 | Professional | 78 · Unplanned return to OR | $6.03 | $6.76 | $7.08 |
Cigna Setting Facility Modifier None Typical Low $5.37 Median $5.37 Typical High $5.75 | Facility | None | $5.37 | $5.37 | $5.75 |
Cigna Setting Professional Modifier None Typical Low $4.57 Median $4.57 Typical High $5.37 | Professional | None | $4.57 | $4.57 | $5.37 |
Moda Health Setting Facility Modifier None Typical Low $2.45 Median $9.12 Typical High $12.30 | Facility | None | $2.45 | $9.12 | $12.30 |
Moda Health Setting Professional Modifier None Typical Low $5.13 Median $9.55 Typical High $12.30 | Professional | None | $5.13 | $9.55 | $12.30 |
Molina Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | None | $6.31 | $6.31 | $6.31 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $6.17 Median $11.48 Typical High $549.54 | Facility | None | $6.17 | $11.48 | $549.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $9.12 Median $11.48 Typical High $645.65 | Professional | None | $9.12 | $11.48 | $645.65 |
Regence BlueShield Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $9.55 | Professional | None | $6.46 | $6.46 | $9.55 |
Select Health Setting Facility Modifier None Typical Low $8.51 Median $9.12 Typical High $11.75 | Facility | None | $8.51 | $9.12 | $11.75 |
Select Health Setting Professional Modifier None Typical Low $5.89 Median $9.12 Typical High $10.00 | Professional | None | $5.89 | $9.12 | $10.00 |
United Setting Professional Modifier None Typical Low $3.55 Median $3.80 Typical High $5.89 | Professional | None | $3.55 | $3.80 | $5.89 |
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 $0.76 Median $1.82 Typical High $1.82 | Professional | 55 · Aftercare only | $0.76 | $1.82 | $1.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.51 Median $1.23 Typical High $1.23 | Professional | 56 · Pre-op care only | $0.51 | $1.23 | $1.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.76 Median $1.82 Typical High $1.82 | Professional | 55 · Aftercare only | $0.76 | $1.82 | $1.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.51 Median $1.23 Typical High $1.23 | Professional | 56 · Pre-op care only | $0.51 | $1.23 | $1.23 |
Where Idaho sits
The same service costs 4.2 times more in Hawaii 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· 4th of 51
$9.55
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.