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 $1.12 Median $2.63 Typical High $2.63 | Professional | None | $1.12 | $2.63 | $2.63 |
BCBS Idaho Setting Facility Modifier None Typical Low $1.41 Median $1.86 Typical High $3.16 | Facility | None | $1.41 | $1.86 | $3.16 |
BCBS Idaho Setting Professional Modifier None Typical Low $1.38 Median $2.09 Typical High $2.19 | Professional | None | $1.38 | $2.09 | $2.19 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1.29 Median $1.45 Typical High $1.51 | Professional | 78 · Unplanned return to OR | $1.29 | $1.45 | $1.51 |
Cigna Setting Facility Modifier None Typical Low $1.20 Median $1.20 Typical High $1.29 | Facility | None | $1.20 | $1.20 | $1.29 |
Cigna Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $1.20 | Professional | None | $1.02 | $1.02 | $1.20 |
Moda Health Setting Facility Modifier None Typical Low $0.55 Median $1.91 Typical High $2.63 | Facility | None | $0.55 | $1.91 | $2.63 |
Moda Health Setting Professional Modifier None Typical Low $1.48 Median $2.09 Typical High $2.63 | Professional | None | $1.48 | $2.09 | $2.63 |
Molina Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $1.38 | Professional | None | $1.38 | $1.38 | $1.38 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $1.58 Median $2.51 Typical High $120.23 | Facility | None | $1.58 | $2.51 | $120.23 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2.00 Median $2.51 Typical High $141.25 | Professional | None | $2.00 | $2.51 | $141.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $2.09 | Professional | None | $1.38 | $1.38 | $2.09 |
Select Health Setting Facility Modifier None Typical Low $1.86 Median $2.00 Typical High $2.57 | Facility | None | $1.86 | $2.00 | $2.57 |
Select Health Setting Professional Modifier None Typical Low $1.29 Median $2.00 Typical High $2.19 | Professional | None | $1.29 | $2.00 | $2.19 |
United Setting Professional Modifier None Typical Low $0.78 Median $0.85 Typical High $1.51 | Professional | None | $0.78 | $0.85 | $1.51 |
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 $0.17 Median $0.40 Typical High $0.40 | Professional | 55 · Aftercare only | $0.17 | $0.40 | $0.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.26 Typical High $0.26 | Professional | 56 · Pre-op care only | $0.11 | $0.26 | $0.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.17 Median $0.40 Typical High $0.40 | Professional | 55 · Aftercare only | $0.17 | $0.40 | $0.40 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.26 Typical High $0.26 | Professional | 56 · Pre-op care only | $0.11 | $0.26 | $0.26 |
Where Idaho sits
The same service costs 2.1 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
$2.09
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.