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 $14.45 Median $34.67 Typical High $34.67 | Professional | None | $14.45 | $34.67 | $34.67 |
BCBS Idaho Setting Facility Modifier None Typical Low $15.49 Median $23.99 Typical High $41.69 | Facility | None | $15.49 | $23.99 | $41.69 |
BCBS Idaho Setting Professional Modifier None Typical Low $18.20 Median $27.54 Typical High $28.84 | Professional | None | $18.20 | $27.54 | $28.84 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $16.98 Median $19.05 Typical High $19.95 | Professional | 78 · Unplanned return to OR | $16.98 | $19.05 | $19.95 |
Cigna Setting Facility Modifier None Typical Low $15.49 Median $15.49 Typical High $16.60 | Facility | None | $15.49 | $15.49 | $16.60 |
Cigna Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $15.49 | Professional | None | $13.18 | $13.18 | $15.49 |
Moda Health Setting Facility Modifier None Typical Low $7.08 Median $25.12 Typical High $34.67 | Facility | None | $7.08 | $25.12 | $34.67 |
Moda Health Setting Professional Modifier None Typical Low $18.62 Median $27.54 Typical High $34.67 | Professional | None | $18.62 | $27.54 | $34.67 |
Molina Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $20.89 Median $32.36 Typical High $1,584.89 | Facility | None | $20.89 | $32.36 | $1,584.89 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $26.30 Median $32.36 Typical High $1,862.09 | Professional | None | $26.30 | $32.36 | $1,862.09 |
Regence BlueShield Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $27.54 | Professional | None | $18.20 | $18.20 | $27.54 |
Select Health Setting Facility Modifier None Typical Low $26.30 Median $26.30 Typical High $33.88 | Facility | None | $26.30 | $26.30 | $33.88 |
Select Health Setting Professional Modifier None Typical Low $16.98 Median $26.30 Typical High $28.84 | Professional | None | $16.98 | $26.30 | $28.84 |
United Setting Professional Modifier None Typical Low $10.00 Median $10.96 Typical High $17.38 | Professional | None | $10.00 | $10.96 | $17.38 |
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 $2.19 Median $5.25 Typical High $5.25 | Professional | 55 · Aftercare only | $2.19 | $5.25 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $3.47 Typical High $3.47 | Professional | 56 · Pre-op care only | $1.45 | $3.47 | $3.47 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.19 Median $5.25 Typical High $5.25 | Professional | 55 · Aftercare only | $2.19 | $5.25 | $5.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $3.47 Typical High $3.47 | Professional | 56 · Pre-op care only | $1.45 | $3.47 | $3.47 |
Where Idaho sits
The same service costs 3.5 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· 4th of 51
$27.54
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.