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 $38.02 Median $91.20 Typical High $91.20 | Professional | None | $38.02 | $91.20 | $91.20 |
BCBS Idaho Setting Facility Modifier None Typical Low $47.86 Median $61.66 Typical High $107.15 | Facility | None | $47.86 | $61.66 | $107.15 |
BCBS Idaho Setting Professional Modifier None Typical Low $47.86 Median $70.79 Typical High $74.13 | Professional | None | $47.86 | $70.79 | $74.13 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $44.67 Median $50.12 Typical High $52.48 | Professional | 78 · Unplanned return to OR | $44.67 | $50.12 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $42.66 | Facility | None | $39.81 | $39.81 | $42.66 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $39.81 | Professional | None | $33.88 | $33.88 | $39.81 |
Moda Health Setting Facility Modifier None Typical Low $18.20 Median $64.57 Typical High $91.20 | Facility | None | $18.20 | $64.57 | $91.20 |
Moda Health Setting Professional Modifier None Typical Low $48.98 Median $70.79 Typical High $91.20 | Professional | None | $48.98 | $70.79 | $91.20 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $46.77 | Professional | None | $30.20 | $30.20 | $46.77 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $53.70 Median $85.11 Typical High $4,073.80 | Facility | None | $53.70 | $85.11 | $4,073.80 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $67.61 Median $85.11 Typical High $4,786.30 | Professional | None | $67.61 | $85.11 | $4,786.30 |
Regence BlueShield Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $70.79 | Professional | None | $47.86 | $47.86 | $70.79 |
Select Health Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $87.10 | Facility | None | $67.61 | $67.61 | $87.10 |
Select Health Setting Professional Modifier None Typical Low $43.65 Median $67.61 Typical High $74.13 | Professional | None | $43.65 | $67.61 | $74.13 |
United Setting Professional Modifier None Typical Low $25.70 Median $28.18 Typical High $45.71 | Professional | None | $25.70 | $28.18 | $45.71 |
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 $5.62 Median $13.49 Typical High $13.49 | Professional | 55 · Aftercare only | $5.62 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $9.12 Typical High $9.12 | Professional | 56 · Pre-op care only | $3.80 | $9.12 | $9.12 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $13.49 Typical High $13.49 | Professional | 55 · Aftercare only | $5.62 | $13.49 | $13.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $9.12 Typical High $9.12 | Professional | 56 · Pre-op care only | $3.80 | $9.12 | $9.12 |
Where Idaho sits
The same service costs 5.8 times more in Hawaii than in Kansas. 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· 2nd of 51
$70.79
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.