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 $4.57 Median $10.96 Typical High $10.96 | Professional | None | $4.57 | $10.96 | $10.96 |
BCBS Idaho Setting Facility Modifier None Typical Low $5.89 Median $7.76 Typical High $12.88 | Facility | None | $5.89 | $7.76 | $12.88 |
BCBS Idaho Setting Professional Modifier None Typical Low $5.75 Median $8.51 Typical High $8.91 | Professional | None | $5.75 | $8.51 | $8.91 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $5.37 Median $6.03 Typical High $6.31 | Professional | 78 · Unplanned return to OR | $5.37 | $6.03 | $6.31 |
Cigna Setting Facility Modifier None Typical Low $4.79 Median $4.79 Typical High $5.13 | Facility | None | $4.79 | $4.79 | $5.13 |
Cigna Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $4.79 | Professional | None | $4.07 | $4.07 | $4.79 |
Moda Health Setting Facility Modifier None Typical Low $2.19 Median $7.76 Typical High $10.96 | Facility | None | $2.19 | $7.76 | $10.96 |
Moda Health Setting Professional Modifier None Typical Low $4.57 Median $8.51 Typical High $10.96 | Professional | None | $4.57 | $8.51 | $10.96 |
Molina Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $30.20 | Professional | None | $5.62 | $5.62 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $6.46 Median $10.23 Typical High $489.78 | Facility | None | $6.46 | $10.23 | $489.78 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $8.51 Median $10.23 Typical High $575.44 | Professional | None | $8.51 | $10.23 | $575.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $5.75 Median $5.75 Typical High $8.51 | Professional | None | $5.75 | $5.75 | $8.51 |
Select Health Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $10.47 | Facility | None | $8.13 | $8.13 | $10.47 |
Select Health Setting Professional Modifier None Typical Low $5.25 Median $8.13 Typical High $8.91 | Professional | None | $5.25 | $8.13 | $8.91 |
United Setting Professional Modifier None Typical Low $3.09 Median $3.39 Typical High $5.37 | Professional | None | $3.09 | $3.39 | $5.37 |
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 $0.68 Median $1.62 Typical High $1.62 | Professional | 55 · Aftercare only | $0.68 | $1.62 | $1.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.45 Median $1.10 Typical High $1.10 | Professional | 56 · Pre-op care only | $0.45 | $1.10 | $1.10 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.68 Median $1.62 Typical High $1.62 | Professional | 55 · Aftercare only | $0.68 | $1.62 | $1.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.45 Median $1.10 Typical High $1.10 | Professional | 56 · Pre-op care only | $0.45 | $1.10 | $1.10 |
Where Idaho sits
The same service costs 2.3 times more in Kansas than in Utah. 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· 2nd of 51
$8.51
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.