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 $12.02 Median $28.18 Typical High $28.18 | Professional | None | $12.02 | $28.18 | $28.18 |
BCBS Idaho Setting Facility Modifier None Typical Low $13.80 Median $19.95 Typical High $33.88 | Facility | None | $13.80 | $19.95 | $33.88 |
BCBS Idaho Setting Professional Modifier None Typical Low $15.14 Median $22.39 Typical High $23.44 | Professional | None | $15.14 | $22.39 | $23.44 |
Cigna Setting Facility Modifier None Typical Low $13.80 Median $13.80 Typical High $14.45 | Facility | None | $13.80 | $13.80 | $14.45 |
Cigna Setting Professional Modifier None Typical Low $8.71 Median $11.75 Typical High $11.75 | Professional | None | $8.71 | $11.75 | $11.75 |
Moda Health Setting Facility Modifier None Typical Low $5.75 Median $20.42 Typical High $28.18 | Facility | None | $5.75 | $20.42 | $28.18 |
Moda Health Setting Professional Modifier None Typical Low $15.49 Median $22.39 Typical High $28.18 | Professional | None | $15.49 | $22.39 | $28.18 |
Molina Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $30.20 | Professional | None | $14.79 | $14.79 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $16.98 Median $26.92 Typical High $1,288.25 | Facility | None | $16.98 | $26.92 | $1,288.25 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $21.38 Median $26.92 Typical High $1,513.56 | Professional | None | $21.38 | $26.92 | $1,513.56 |
Regence BlueShield Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $22.39 | Professional | None | $15.14 | $15.14 | $22.39 |
Select Health Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $27.54 | Facility | None | $21.38 | $21.38 | $27.54 |
Select Health Setting Professional Modifier None Typical Low $13.80 Median $21.38 Typical High $23.44 | Professional | None | $13.80 | $21.38 | $23.44 |
United Setting Professional Modifier None Typical Low $8.13 Median $8.91 Typical High $14.13 | Professional | None | $8.13 | $8.91 | $14.13 |
5 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 $1.78 Median $4.27 Typical High $4.27 | Professional | 55 · Aftercare only | $1.78 | $4.27 | $4.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.20 Median $2.82 Typical High $2.82 | Professional | 56 · Pre-op care only | $1.20 | $2.82 | $2.82 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $14.13 Median $15.85 Typical High $16.60 | Professional | 78 · Unplanned return to OR | $14.13 | $15.85 | $16.60 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.78 Median $4.27 Typical High $4.27 | Professional | 55 · Aftercare only | $1.78 | $4.27 | $4.27 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.20 Median $2.82 Typical High $2.82 | Professional | 56 · Pre-op care only | $1.20 | $2.82 | $2.82 |
Where Idaho sits
The same service costs 2.3 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
$21.38
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.