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 $2.82 Median $6.76 Typical High $6.76 | Professional | None | $2.82 | $6.76 | $6.76 |
BCBS Idaho Setting Facility Modifier None Typical Low $3.09 Median $4.68 Typical High $8.32 | Facility | None | $3.09 | $4.68 | $8.32 |
BCBS Idaho Setting Professional Modifier None Typical Low $3.55 Median $5.25 Typical High $5.50 | Professional | None | $3.55 | $5.25 | $5.50 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3.31 Median $3.72 Typical High $3.89 | Professional | 78 · Unplanned return to OR | $3.31 | $3.72 | $3.89 |
Cigna Setting Facility Modifier None Typical Low $2.95 Median $2.95 Typical High $3.16 | Facility | None | $2.95 | $2.95 | $3.16 |
Cigna Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $2.95 | Professional | None | $2.51 | $2.51 | $2.95 |
Moda Health Setting Facility Modifier None Typical Low $1.35 Median $4.79 Typical High $6.76 | Facility | None | $1.35 | $4.79 | $6.76 |
Moda Health Setting Professional Modifier None Typical Low $3.63 Median $5.25 Typical High $6.76 | Professional | None | $3.63 | $5.25 | $6.76 |
Molina Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | None | $3.47 | $3.47 | $3.47 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $3.98 Median $6.31 Typical High $302.00 | Facility | None | $3.98 | $6.31 | $302.00 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $5.25 Median $6.31 Typical High $354.81 | Professional | None | $5.25 | $6.31 | $354.81 |
Regence BlueShield Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $5.25 | Professional | None | $3.55 | $3.55 | $5.25 |
Select Health Setting Facility Modifier None Typical Low $5.01 Median $5.01 Typical High $6.46 | Facility | None | $5.01 | $5.01 | $6.46 |
Select Health Setting Professional Modifier None Typical Low $3.31 Median $5.01 Typical High $5.50 | Professional | None | $3.31 | $5.01 | $5.50 |
United Setting Professional Modifier None Typical Low $1.91 Median $2.09 Typical High $3.24 | Professional | None | $1.91 | $2.09 | $3.24 |
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 $0.42 Median $1.00 Typical High $1.00 | Professional | 55 · Aftercare only | $0.42 | $1.00 | $1.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.68 Typical High $0.68 | Professional | 56 · Pre-op care only | $0.28 | $0.68 | $0.68 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.42 Median $1.00 Typical High $1.00 | Professional | 55 · Aftercare only | $0.42 | $1.00 | $1.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.68 Typical High $0.68 | Professional | 56 · Pre-op care only | $0.28 | $0.68 | $0.68 |
Where Idaho sits
The same service costs 2.1 times more in Montana than in Colorado. 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
$5.25
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.