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 $34.67 Median $93.33 Typical High $93.33 | Professional | None | $34.67 | $93.33 | $93.33 |
BCBS Idaho Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $109.65 | Facility | None | $50.12 | $66.07 | $109.65 |
BCBS Idaho Setting Professional Modifier None Typical Low $48.98 Median $72.44 Typical High $75.86 | Professional | None | $48.98 | $72.44 | $75.86 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $45.71 Median $51.29 Typical High $53.70 | Professional | 78 · Unplanned return to OR | $45.71 | $51.29 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $43.65 | Facility | None | $40.74 | $40.74 | $43.65 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $40.74 | Professional | None | $34.67 | $34.67 | $40.74 |
Moda Health Setting Facility Modifier None Typical Low $18.62 Median $66.07 Typical High $93.33 | Facility | None | $18.62 | $66.07 | $93.33 |
Moda Health Setting Professional Modifier None Typical Low $45.71 Median $72.44 Typical High $93.33 | Professional | None | $45.71 | $72.44 | $93.33 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $46.77 Median $87.10 Typical High $4,168.69 | Facility | None | $46.77 | $87.10 | $4,168.69 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $69.18 Median $87.10 Typical High $4,897.79 | Professional | None | $69.18 | $87.10 | $4,897.79 |
Regence BlueShield Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $72.44 | Professional | None | $48.98 | $48.98 | $72.44 |
Select Health Setting Facility Modifier None Typical Low $66.07 Median $69.18 Typical High $89.13 | Facility | None | $66.07 | $69.18 | $89.13 |
Select Health Setting Professional Modifier None Typical Low $45.71 Median $69.18 Typical High $75.86 | Professional | None | $45.71 | $69.18 | $75.86 |
United Setting Professional Modifier None Typical Low $26.30 Median $28.84 Typical High $44.67 | Professional | None | $26.30 | $28.84 | $44.67 |
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 $5.25 Median $13.80 Typical High $13.80 | Professional | 55 · Aftercare only | $5.25 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $9.33 Typical High $9.33 | Professional | 56 · Pre-op care only | $3.55 | $9.33 | $9.33 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $13.80 Typical High $13.80 | Professional | 55 · Aftercare only | $5.25 | $13.80 | $13.80 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $9.33 Typical High $9.33 | Professional | 56 · Pre-op care only | $3.55 | $9.33 | $9.33 |
Where Idaho sits
The same service costs 3.0 times more in Hawaii than in Rhode Island. 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
$72.44
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.