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 $2.75 Median $6.61 Typical High $6.61 | Professional | None | $2.75 | $6.61 | $6.61 |
BCBS Idaho Setting Facility Modifier None Typical Low $3.55 Median $4.68 Typical High $8.32 | Facility | None | $3.55 | $4.68 | $8.32 |
BCBS Idaho Setting Professional Modifier None Typical Low $3.47 Median $5.25 Typical High $5.50 | Professional | None | $3.47 | $5.25 | $5.50 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3.24 Median $3.63 Typical High $3.80 | Professional | 78 · Unplanned return to OR | $3.24 | $3.63 | $3.80 |
Cigna Setting Facility Modifier None Typical Low $2.95 Median $2.95 Typical High $3.09 | Facility | None | $2.95 | $2.95 | $3.09 |
Cigna Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $2.95 | Professional | None | $2.45 | $2.45 | $2.95 |
Moda Health Setting Facility Modifier None Typical Low $1.32 Median $4.47 Typical High $6.61 | Facility | None | $1.32 | $4.47 | $6.61 |
Moda Health Setting Professional Modifier None Typical Low $3.02 Median $5.25 Typical High $6.61 | Professional | None | $3.02 | $5.25 | $6.61 |
Molina Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | None | $3.47 | $3.47 | $3.47 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $3.47 Median $6.17 Typical High $295.12 | Facility | None | $3.47 | $6.17 | $295.12 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $4.90 Median $6.17 Typical High $346.74 | Professional | None | $4.90 | $6.17 | $346.74 |
Regence BlueShield Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $5.25 | Professional | None | $3.47 | $3.47 | $5.25 |
Select Health Setting Facility Modifier None Typical Low $4.57 Median $4.90 Typical High $6.31 | Facility | None | $4.57 | $4.90 | $6.31 |
Select Health Setting Professional Modifier None Typical Low $3.24 Median $4.90 Typical High $5.37 | Professional | None | $3.24 | $4.90 | $5.37 |
United Setting Professional Modifier None Typical Low $1.91 Median $2.04 Typical High $3.24 | Professional | None | $1.91 | $2.04 | $3.24 |
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 $0.41 Median $1.00 Typical High $1.00 | Professional | 55 · Aftercare only | $0.41 | $1.00 | $1.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.66 Typical High $0.66 | Professional | 56 · Pre-op care only | $0.28 | $0.66 | $0.66 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.41 Median $1.00 Typical High $1.00 | Professional | 55 · Aftercare only | $0.41 | $1.00 | $1.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.66 Typical High $0.66 | Professional | 56 · Pre-op care only | $0.28 | $0.66 | $0.66 |
Where Idaho sits
The same service costs 5.5 times more in Kansas than in Delaware. 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· 3rd of 51
$5.13
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.