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 $3.63 Median $8.71 Typical High $8.71 | Professional | None | $3.63 | $8.71 | $8.71 |
BCBS Idaho Setting Facility Modifier None Typical Low $4.68 Median $6.31 Typical High $10.47 | Facility | None | $4.68 | $6.31 | $10.47 |
BCBS Idaho Setting Professional Modifier None Typical Low $4.57 Median $6.92 Typical High $7.24 | Professional | None | $4.57 | $6.92 | $7.24 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $4.37 Median $4.79 Typical High $5.13 | Professional | 78 · Unplanned return to OR | $4.37 | $4.79 | $5.13 |
Cigna Setting Facility Modifier None Typical Low $3.89 Median $3.89 Typical High $4.17 | Facility | None | $3.89 | $3.89 | $4.17 |
Cigna Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $3.89 | Professional | None | $3.31 | $3.31 | $3.89 |
Moda Health Setting Facility Modifier None Typical Low $1.78 Median $6.31 Typical High $8.71 | Facility | None | $1.78 | $6.31 | $8.71 |
Moda Health Setting Professional Modifier None Typical Low $4.79 Median $6.92 Typical High $8.71 | Professional | None | $4.79 | $6.92 | $8.71 |
Molina Setting Professional Modifier None Typical Low $4.57 Median $6.92 Typical High $30.20 | Professional | None | $4.57 | $6.92 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $5.25 Median $8.32 Typical High $398.11 | Facility | None | $5.25 | $8.32 | $398.11 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $6.92 Median $8.32 Typical High $467.74 | Professional | None | $6.92 | $8.32 | $467.74 |
Regence BlueShield Setting Professional Modifier None Typical Low $4.57 Median $4.57 Typical High $6.92 | Professional | None | $4.57 | $4.57 | $6.92 |
Select Health Setting Facility Modifier None Typical Low $6.61 Median $6.61 Typical High $8.32 | Facility | None | $6.61 | $6.61 | $8.32 |
Select Health Setting Professional Modifier None Typical Low $4.27 Median $6.61 Typical High $7.24 | Professional | None | $4.27 | $6.61 | $7.24 |
United Setting Professional Modifier None Typical Low $2.51 Median $2.75 Typical High $4.27 | Professional | None | $2.51 | $2.75 | $4.27 |
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 $0.55 Median $1.32 Typical High $1.32 | Professional | 55 · Aftercare only | $0.55 | $1.32 | $1.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.37 Median $0.87 Typical High $0.87 | Professional | 56 · Pre-op care only | $0.37 | $0.87 | $0.87 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.55 Median $1.32 Typical High $1.32 | Professional | 55 · Aftercare only | $0.55 | $1.32 | $1.32 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.37 Median $0.87 Typical High $0.87 | Professional | 56 · Pre-op care only | $0.37 | $0.87 | $0.87 |
Where Idaho sits
The same service costs 2.6 times more in Kansas than in New Hampshire. 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
$6.92
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.