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 $5.37 Median $13.18 Typical High $13.18 | Professional | None | $5.37 | $13.18 | $13.18 |
BCBS Idaho Setting Facility Modifier None Typical Low $7.08 Median $9.33 Typical High $15.49 | Facility | None | $7.08 | $9.33 | $15.49 |
BCBS Idaho Setting Professional Modifier None Typical Low $6.92 Median $10.23 Typical High $10.72 | Professional | None | $6.92 | $10.23 | $10.72 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $6.46 Median $7.24 Typical High $7.59 | Professional | 78 · Unplanned return to OR | $6.46 | $7.24 | $7.59 |
Cigna Setting Facility Modifier None Typical Low $6.17 Median $6.17 Typical High $6.61 | Facility | None | $6.17 | $6.17 | $6.61 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $6.17 | Professional | None | $5.25 | $5.25 | $6.17 |
Moda Health Setting Facility Modifier None Typical Low $2.82 Median $9.77 Typical High $13.18 | Facility | None | $2.82 | $9.77 | $13.18 |
Moda Health Setting Professional Modifier None Typical Low $7.59 Median $10.23 Typical High $13.18 | Professional | None | $7.59 | $10.23 | $13.18 |
Molina Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | None | $6.76 | $6.76 | $6.76 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $7.94 Median $12.30 Typical High $588.84 | Facility | None | $7.94 | $12.30 | $588.84 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $9.77 Median $12.30 Typical High $691.83 | Professional | None | $9.77 | $12.30 | $691.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $10.23 | Professional | None | $6.92 | $6.92 | $10.23 |
Select Health Setting Facility Modifier None Typical Low $9.77 Median $9.77 Typical High $12.59 | Facility | None | $9.77 | $9.77 | $12.59 |
Select Health Setting Professional Modifier None Typical Low $6.31 Median $9.77 Typical High $10.72 | Professional | None | $6.31 | $9.77 | $10.72 |
United Setting Professional Modifier None Typical Low $3.98 Median $4.37 Typical High $6.76 | Professional | None | $3.98 | $4.37 | $6.76 |
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 $0.81 Median $1.95 Typical High $1.95 | Professional | 55 · Aftercare only | $0.81 | $1.95 | $1.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.54 Median $1.32 Typical High $1.32 | Professional | 56 · Pre-op care only | $0.54 | $1.32 | $1.32 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.81 Median $1.95 Typical High $1.95 | Professional | 55 · Aftercare only | $0.81 | $1.95 | $1.95 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.54 Median $1.32 Typical High $1.32 | Professional | 56 · Pre-op care only | $0.54 | $1.32 | $1.32 |
Where Idaho sits
The same service costs 2.1 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· 3rd of 51
$10.23
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.