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 $1.62 Median $3.89 Typical High $3.89 | Professional | None | $1.62 | $3.89 | $3.89 |
BCBS Idaho Setting Facility Modifier None Typical Low $2.09 Median $2.82 Typical High $5.13 | Facility | None | $2.09 | $2.82 | $5.13 |
BCBS Idaho Setting Professional Modifier None Typical Low $2.04 Median $3.09 Typical High $3.24 | Professional | None | $2.04 | $3.09 | $3.24 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1.91 Median $2.14 Typical High $2.24 | Professional | 78 · Unplanned return to OR | $1.91 | $2.14 | $2.24 |
Cigna Setting Facility Modifier None Typical Low $2.04 Median $2.04 Typical High $2.14 | Facility | None | $2.04 | $2.04 | $2.14 |
Cigna Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $2.04 | Professional | None | $1.74 | $1.74 | $2.04 |
Moda Health Setting Facility Modifier None Typical Low $0.93 Median $2.95 Typical High $3.89 | Facility | None | $0.93 | $2.95 | $3.89 |
Moda Health Setting Professional Modifier None Typical Low $2.14 Median $3.09 Typical High $3.89 | Professional | None | $2.14 | $3.09 | $3.89 |
Molina Setting Professional Modifier None Typical Low $2.04 Median $2.04 Typical High $30.20 | Professional | None | $2.04 | $2.04 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $2.29 Median $3.63 Typical High $177.83 | Facility | None | $2.29 | $3.63 | $177.83 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2.95 Median $3.63 Typical High $208.93 | Professional | None | $2.95 | $3.63 | $208.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $2.04 Median $2.04 Typical High $3.09 | Professional | None | $2.04 | $2.04 | $3.09 |
Select Health Setting Facility Modifier None Typical Low $2.95 Median $2.95 Typical High $6.31 | Facility | None | $2.95 | $2.95 | $6.31 |
Select Health Setting Professional Modifier None Typical Low $1.91 Median $2.95 Typical High $3.24 | Professional | None | $1.91 | $2.95 | $3.24 |
United Setting Professional Modifier None Typical Low $1.32 Median $1.45 Typical High $2.04 | Professional | None | $1.32 | $1.45 | $2.04 |
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 $0.25 Median $0.59 Typical High $0.59 | Professional | 55 · Aftercare only | $0.25 | $0.59 | $0.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.16 Median $0.39 Typical High $0.39 | Professional | 56 · Pre-op care only | $0.16 | $0.39 | $0.39 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.25 Median $0.59 Typical High $0.59 | Professional | 55 · Aftercare only | $0.25 | $0.59 | $0.59 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.16 Median $0.39 Typical High $0.39 | Professional | 56 · Pre-op care only | $0.16 | $0.39 | $0.39 |
Where Idaho sits
The same service costs 3.8 times more in Kansas than in Alabama. 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
$3.09
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.