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 $1.41 Median $3.39 Typical High $3.39 | Professional | None | $1.41 | $3.39 | $3.39 |
BCBS Idaho Setting Facility Modifier None Typical Low $1.82 Median $2.40 Typical High $4.07 | Facility | None | $1.82 | $2.40 | $4.07 |
BCBS Idaho Setting Professional Modifier None Typical Low $1.78 Median $2.69 Typical High $2.82 | Professional | None | $1.78 | $2.69 | $2.82 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1.66 Median $1.86 Typical High $1.95 | Professional | 78 · Unplanned return to OR | $1.66 | $1.86 | $1.95 |
Cigna Setting Facility Modifier None Typical Low $1.51 Median $1.51 Typical High $1.62 | Facility | None | $1.51 | $1.51 | $1.62 |
Cigna Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.51 | Professional | None | $1.29 | $1.29 | $1.51 |
Moda Health Setting Facility Modifier None Typical Low $0.68 Median $2.45 Typical High $3.39 | Facility | None | $0.68 | $2.45 | $3.39 |
Moda Health Setting Professional Modifier None Typical Low $1.82 Median $2.69 Typical High $3.39 | Professional | None | $1.82 | $2.69 | $3.39 |
Molina Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $1.78 | Professional | None | $1.78 | $1.78 | $1.78 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $2.04 Median $3.24 Typical High $154.88 | Facility | None | $2.04 | $3.24 | $154.88 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2.57 Median $3.24 Typical High $181.97 | Professional | None | $2.57 | $3.24 | $181.97 |
Regence BlueShield Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $2.69 | Professional | None | $1.78 | $1.78 | $2.69 |
Select Health Setting Facility Modifier None Typical Low $2.57 Median $2.57 Typical High $3.24 | Facility | None | $2.57 | $2.57 | $3.24 |
Select Health Setting Professional Modifier None Typical Low $1.66 Median $2.57 Typical High $2.82 | Professional | None | $1.66 | $2.57 | $2.82 |
United Setting Professional Modifier None Typical Low $0.98 Median $1.07 Typical High $1.62 | Professional | None | $0.98 | $1.07 | $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 $0.21 Median $0.51 Typical High $0.51 | Professional | 55 · Aftercare only | $0.21 | $0.51 | $0.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.34 Typical High $0.34 | Professional | 56 · Pre-op care only | $0.14 | $0.34 | $0.34 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.21 Median $0.51 Typical High $0.51 | Professional | 55 · Aftercare only | $0.21 | $0.51 | $0.51 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.34 Typical High $0.34 | Professional | 56 · Pre-op care only | $0.14 | $0.34 | $0.34 |
Where Idaho sits
The same service costs 2.1 times more in Idaho than in Connecticut. 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
$2.69
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.