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 $4.79 Median $11.48 Typical High $11.48 | Professional | None | $4.79 | $11.48 | $11.48 |
BCBS Idaho Setting Facility Modifier None Typical Low $6.17 Median $8.13 Typical High $13.80 | Facility | None | $6.17 | $8.13 | $13.80 |
BCBS Idaho Setting Professional Modifier None Typical Low $6.03 Median $8.91 Typical High $9.33 | Professional | None | $6.03 | $8.91 | $9.33 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $5.62 Median $6.31 Typical High $6.61 | Professional | 78 · Unplanned return to OR | $5.62 | $6.31 | $6.61 |
Cigna Setting Facility Modifier None Typical Low $5.01 Median $5.01 Typical High $5.37 | Facility | None | $5.01 | $5.01 | $5.37 |
Cigna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $5.01 | Professional | None | $4.27 | $4.27 | $5.01 |
Moda Health Setting Facility Modifier None Typical Low $2.29 Median $8.13 Typical High $11.48 | Facility | None | $2.29 | $8.13 | $11.48 |
Moda Health Setting Professional Modifier None Typical Low $6.17 Median $8.91 Typical High $11.48 | Professional | None | $6.17 | $8.91 | $11.48 |
Molina Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $30.20 | Professional | None | $5.89 | $5.89 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $6.76 Median $10.72 Typical High $512.86 | Facility | None | $6.76 | $10.72 | $512.86 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $8.51 Median $10.72 Typical High $602.56 | Professional | None | $8.51 | $10.72 | $602.56 |
Regence BlueShield Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $8.91 | Professional | None | $6.03 | $6.03 | $8.91 |
Select Health Setting Facility Modifier None Typical Low $8.51 Median $8.51 Typical High $18.20 | Facility | None | $8.51 | $8.51 | $18.20 |
Select Health Setting Professional Modifier None Typical Low $5.62 Median $8.51 Typical High $9.33 | Professional | None | $5.62 | $8.51 | $9.33 |
United Setting Professional Modifier None Typical Low $3.24 Median $3.55 Typical High $5.89 | Professional | None | $3.24 | $3.55 | $5.89 |
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 $0.71 Median $1.70 Typical High $1.70 | Professional | 55 · Aftercare only | $0.71 | $1.70 | $1.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.47 Median $1.12 Typical High $1.12 | Professional | 56 · Pre-op care only | $0.47 | $1.12 | $1.12 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.71 Median $1.70 Typical High $1.70 | Professional | 55 · Aftercare only | $0.71 | $1.70 | $1.70 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.47 Median $1.15 Typical High $1.15 | Professional | 56 · Pre-op care only | $0.47 | $1.15 | $1.15 |
Where Idaho sits
The same service costs 2.1 times more in Hawaii 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· 2nd of 51
$8.91
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.