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 $1.32 Median $3.16 Typical High $3.16 | Professional | None | $1.32 | $3.16 | $3.16 |
BCBS Idaho Setting Facility Modifier None Typical Low $1.74 Median $2.24 Typical High $3.80 | Facility | None | $1.74 | $2.24 | $3.80 |
BCBS Idaho Setting Professional Modifier None Typical Low $1.66 Median $2.51 Typical High $2.63 | Professional | None | $1.66 | $2.51 | $2.63 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1.55 Median $1.78 Typical High $1.82 | Professional | 78 · Unplanned return to OR | $1.55 | $1.78 | $1.82 |
Cigna Setting Facility Modifier None Typical Low $1.41 Median $1.41 Typical High $1.48 | Facility | None | $1.41 | $1.41 | $1.48 |
Cigna Setting Professional Modifier None Typical Low $1.20 Median $1.20 Typical High $1.41 | Professional | None | $1.20 | $1.20 | $1.41 |
Moda Health Setting Facility Modifier None Typical Low $0.65 Median $2.29 Typical High $3.16 | Facility | None | $0.65 | $2.29 | $3.16 |
Moda Health Setting Professional Modifier None Typical Low $1.45 Median $2.51 Typical High $3.16 | Professional | None | $1.45 | $2.51 | $3.16 |
Molina Setting Professional Modifier None Typical Low $1.66 Median $1.66 Typical High $1.66 | Professional | None | $1.66 | $1.66 | $1.66 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $1.91 Median $3.02 Typical High $144.54 | Facility | None | $1.91 | $3.02 | $144.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2.40 Median $3.02 Typical High $169.82 | Professional | None | $2.40 | $3.02 | $169.82 |
Regence BlueShield Setting Professional Modifier None Typical Low $1.66 Median $1.66 Typical High $2.51 | Professional | None | $1.66 | $1.66 | $2.51 |
Select Health Setting Facility Modifier None Typical Low $2.40 Median $2.40 Typical High $3.09 | Facility | None | $2.40 | $2.40 | $3.09 |
Select Health Setting Professional Modifier None Typical Low $1.55 Median $2.40 Typical High $2.63 | Professional | None | $1.55 | $2.40 | $2.63 |
United Setting Professional Modifier None Typical Low $0.91 Median $1.00 Typical High $1.62 | Professional | None | $0.91 | $1.00 | $1.62 |
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 $0.20 Median $0.48 Typical High $0.48 | Professional | 55 · Aftercare only | $0.20 | $0.48 | $0.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.32 Typical High $0.32 | Professional | 56 · Pre-op care only | $0.13 | $0.32 | $0.32 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.20 Median $0.48 Typical High $0.48 | Professional | 55 · Aftercare only | $0.20 | $0.48 | $0.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.32 Typical High $0.32 | Professional | 56 · Pre-op care only | $0.13 | $0.32 | $0.32 |
Where Idaho sits
The same service costs 5.4 times more in Kansas than in Kentucky. 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
$2.51
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.