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 $2.14 Median $5.13 Typical High $5.13 | Professional | None | $2.14 | $5.13 | $5.13 |
BCBS Idaho Setting Facility Modifier None Typical Low $2.40 Median $3.63 Typical High $6.46 | Facility | None | $2.40 | $3.63 | $6.46 |
BCBS Idaho Setting Professional Modifier None Typical Low $2.69 Median $4.07 Typical High $4.27 | Professional | None | $2.69 | $4.07 | $4.27 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2.51 Median $2.82 Typical High $2.95 | Professional | 78 · Unplanned return to OR | $2.51 | $2.82 | $2.95 |
Cigna Setting Facility Modifier None Typical Low $2.29 Median $2.29 Typical High $2.45 | Facility | None | $2.29 | $2.29 | $2.45 |
Cigna Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $2.29 | Professional | None | $1.95 | $1.95 | $2.29 |
Moda Health Setting Facility Modifier None Typical Low $1.05 Median $3.63 Typical High $5.13 | Facility | None | $1.05 | $3.63 | $5.13 |
Moda Health Setting Professional Modifier None Typical Low $2.14 Median $4.07 Typical High $5.13 | Professional | None | $2.14 | $4.07 | $5.13 |
Molina Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | None | $2.69 | $2.69 | $2.69 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $3.02 Median $4.79 Typical High $229.09 | Facility | None | $3.02 | $4.79 | $229.09 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $3.89 Median $4.79 Typical High $269.15 | Professional | None | $3.89 | $4.79 | $269.15 |
Regence BlueShield Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $4.07 | Professional | None | $2.69 | $2.69 | $4.07 |
Select Health Setting Facility Modifier None Typical Low $3.89 Median $3.89 Typical High $4.90 | Facility | None | $3.89 | $3.89 | $4.90 |
Select Health Setting Professional Modifier None Typical Low $2.51 Median $3.89 Typical High $4.27 | Professional | None | $2.51 | $3.89 | $4.27 |
United Setting Professional Modifier None Typical Low $1.48 Median $1.58 Typical High $2.69 | Professional | None | $1.48 | $1.58 | $2.69 |
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 $0.32 Median $0.78 Typical High $0.78 | Professional | 55 · Aftercare only | $0.32 | $0.78 | $0.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.21 Median $0.51 Typical High $0.51 | Professional | 56 · Pre-op care only | $0.21 | $0.51 | $0.51 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.32 Median $0.78 Typical High $0.78 | Professional | 55 · Aftercare only | $0.32 | $0.78 | $0.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.21 Median $0.51 Typical High $0.51 | Professional | 56 · Pre-op care only | $0.21 | $0.51 | $0.51 |
Where Idaho sits
The same service costs 2.1 times more in Idaho than in New Jersey. 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
$4.07
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.