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 $7.08 Median $16.98 Typical High $16.98 | Professional | None | $7.08 | $16.98 | $16.98 |
BCBS Idaho Setting Facility Modifier None Typical Low $7.94 Median $12.02 Typical High $20.89 | Facility | None | $7.94 | $12.02 | $20.89 |
BCBS Idaho Setting Professional Modifier None Typical Low $9.12 Median $13.49 Typical High $14.13 | Professional | None | $9.12 | $13.49 | $14.13 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $8.51 Median $9.55 Typical High $10.00 | Professional | 78 · Unplanned return to OR | $8.51 | $9.55 | $10.00 |
Cigna Setting Facility Modifier None Typical Low $7.59 Median $7.59 Typical High $8.13 | Facility | None | $7.59 | $7.59 | $8.13 |
Cigna Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $7.59 | Professional | None | $6.46 | $6.46 | $7.59 |
Moda Health Setting Facility Modifier None Typical Low $3.47 Median $12.30 Typical High $16.98 | Facility | None | $3.47 | $12.30 | $16.98 |
Moda Health Setting Professional Modifier None Typical Low $9.33 Median $13.49 Typical High $16.98 | Professional | None | $9.33 | $13.49 | $16.98 |
Molina Setting Professional Modifier None Typical Low $8.91 Median $8.91 Typical High $30.20 | Professional | None | $8.91 | $8.91 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $10.23 Median $16.22 Typical High $776.25 | Facility | None | $10.23 | $16.22 | $776.25 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $13.49 Median $16.22 Typical High $912.01 | Professional | None | $13.49 | $16.22 | $912.01 |
Regence BlueShield Setting Professional Modifier None Typical Low $9.12 Median $9.12 Typical High $13.49 | Professional | None | $9.12 | $9.12 | $13.49 |
Select Health Setting Facility Modifier None Typical Low $12.88 Median $12.88 Typical High $16.60 | Facility | None | $12.88 | $12.88 | $16.60 |
Select Health Setting Professional Modifier None Typical Low $8.32 Median $12.88 Typical High $14.13 | Professional | None | $8.32 | $12.88 | $14.13 |
United Setting Professional Modifier None Typical Low $4.90 Median $5.37 Typical High $8.51 | Professional | None | $4.90 | $5.37 | $8.51 |
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 $1.07 Median $2.57 Typical High $2.57 | Professional | 55 · Aftercare only | $1.07 | $2.57 | $2.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.72 Median $1.70 Typical High $1.70 | Professional | 56 · Pre-op care only | $0.72 | $1.70 | $1.70 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.07 Median $2.57 Typical High $2.57 | Professional | 55 · Aftercare only | $1.07 | $2.57 | $2.57 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.72 Median $1.70 Typical High $1.70 | Professional | 56 · Pre-op care only | $0.72 | $1.70 | $1.70 |
Where Idaho sits
The same service costs 2.1 times more in Idaho 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· 1st of 51
$13.49
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.