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 $22.39 Median $53.70 Typical High $53.70 | Professional | None | $22.39 | $53.70 | $53.70 |
BCBS Idaho Setting Facility Modifier None Typical Low $28.84 Median $38.02 Typical High $63.10 | Facility | None | $28.84 | $38.02 | $63.10 |
BCBS Idaho Setting Professional Modifier None Typical Low $28.18 Median $42.66 Typical High $44.67 | Professional | None | $28.18 | $42.66 | $44.67 |
Cigna Setting Facility Modifier None Typical Low $26.30 Median $26.30 Typical High $27.54 | Facility | None | $26.30 | $26.30 | $27.54 |
Cigna Setting Professional Modifier None Typical Low $16.22 Median $22.39 Typical High $22.39 | Professional | None | $16.22 | $22.39 | $22.39 |
Moda Health Setting Facility Modifier None Typical Low $10.72 Median $38.02 Typical High $53.70 | Facility | None | $10.72 | $38.02 | $53.70 |
Moda Health Setting Professional Modifier None Typical Low $28.84 Median $42.66 Typical High $53.70 | Professional | None | $28.84 | $42.66 | $53.70 |
Molina Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $30.20 | Professional | None | $28.18 | $28.18 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $31.62 Median $50.12 Typical High $2,398.83 | Facility | None | $31.62 | $50.12 | $2,398.83 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $39.81 Median $50.12 Typical High $2,818.38 | Professional | None | $39.81 | $50.12 | $2,818.38 |
Regence BlueShield Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $42.66 | Professional | None | $28.18 | $28.18 | $42.66 |
Select Health Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $51.29 | Facility | None | $39.81 | $39.81 | $51.29 |
Select Health Setting Professional Modifier None Typical Low $26.30 Median $39.81 Typical High $43.65 | Professional | None | $26.30 | $39.81 | $43.65 |
United Setting Professional Modifier None Typical Low $15.14 Median $16.60 Typical High $26.30 | Professional | None | $15.14 | $16.60 | $26.30 |
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 $3.39 Median $7.94 Typical High $7.94 | Professional | 55 · Aftercare only | $3.39 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.24 Median $5.37 Typical High $5.37 | Professional | 56 · Pre-op care only | $2.24 | $5.37 | $5.37 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $26.30 Median $29.51 Typical High $30.90 | Professional | 78 · Unplanned return to OR | $26.30 | $29.51 | $30.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.39 Median $7.94 Typical High $7.94 | Professional | 55 · Aftercare only | $3.39 | $7.94 | $7.94 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.24 Median $5.37 Typical High $5.37 | Professional | 56 · Pre-op care only | $2.24 | $5.37 | $5.37 |
Where Idaho sits
The same service costs 3.0 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· 3rd of 51
$39.81
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.