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 $7.76 Median $18.62 Typical High $18.62 | Professional | None | $7.76 | $18.62 | $18.62 |
BCBS Idaho Setting Facility Modifier None Typical Low $8.71 Median $13.18 Typical High $22.91 | Facility | None | $8.71 | $13.18 | $22.91 |
BCBS Idaho Setting Professional Modifier None Typical Low $9.77 Median $14.79 Typical High $15.49 | Professional | None | $9.77 | $14.79 | $15.49 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $9.12 Median $10.23 Typical High $10.96 | Professional | 78 · Unplanned return to OR | $9.12 | $10.23 | $10.96 |
Cigna Setting Facility Modifier None Typical Low $8.32 Median $8.32 Typical High $8.91 | Facility | None | $8.32 | $8.32 | $8.91 |
Cigna Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $8.32 | Professional | None | $7.08 | $7.08 | $8.32 |
Moda Health Setting Facility Modifier None Typical Low $3.80 Median $13.49 Typical High $18.62 | Facility | None | $3.80 | $13.49 | $18.62 |
Moda Health Setting Professional Modifier None Typical Low $10.00 Median $14.79 Typical High $18.62 | Professional | None | $10.00 | $14.79 | $18.62 |
Molina Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $30.20 | Professional | None | $9.77 | $9.77 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $11.22 Median $17.78 Typical High $851.14 | Facility | None | $11.22 | $17.78 | $851.14 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $14.13 Median $17.78 Typical High $1,000.00 | Professional | None | $14.13 | $17.78 | $1,000.00 |
Regence BlueShield Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $14.79 | Professional | None | $9.77 | $9.77 | $14.79 |
Select Health Setting Facility Modifier None Typical Low $14.13 Median $14.13 Typical High $18.20 | Facility | None | $14.13 | $14.13 | $18.20 |
Select Health Setting Professional Modifier None Typical Low $9.12 Median $14.13 Typical High $15.49 | Professional | None | $9.12 | $14.13 | $15.49 |
United Setting Professional Modifier None Typical Low $5.37 Median $5.89 Typical High $9.12 | Professional | None | $5.37 | $5.89 | $9.12 |
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 $1.17 Median $2.82 Typical High $2.82 | Professional | 55 · Aftercare only | $1.17 | $2.82 | $2.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.78 Median $1.86 Typical High $1.86 | Professional | 56 · Pre-op care only | $0.78 | $1.86 | $1.86 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.17 Median $2.82 Typical High $2.82 | Professional | 55 · Aftercare only | $1.17 | $2.82 | $2.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.78 Median $1.86 Typical High $1.86 | Professional | 56 · Pre-op care only | $0.78 | $1.86 | $1.86 |
Where Idaho sits
The same service costs 2.1 times more in Idaho than in Delaware. 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
$14.79
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.