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 $2.24 Median $5.37 Typical High $5.37 | Professional | None | $2.24 | $5.37 | $5.37 |
BCBS Idaho Setting Facility Modifier None Typical Low $2.82 Median $3.72 Typical High $6.31 | Facility | None | $2.82 | $3.72 | $6.31 |
BCBS Idaho Setting Professional Modifier None Typical Low $2.82 Median $4.17 Typical High $4.37 | Professional | None | $2.82 | $4.17 | $4.37 |
Cigna Setting Facility Modifier None Typical Low $2.57 Median $2.57 Typical High $2.75 | Facility | None | $2.57 | $2.57 | $2.75 |
Cigna Setting Professional Modifier None Typical Low $1.91 Median $2.19 Typical High $2.19 | Professional | None | $1.91 | $2.19 | $2.19 |
Moda Health Setting Facility Modifier None Typical Low $1.26 Median $3.80 Typical High $5.37 | Facility | None | $1.26 | $3.80 | $5.37 |
Moda Health Setting Professional Modifier None Typical Low $3.16 Median $4.17 Typical High $5.37 | Professional | None | $3.16 | $4.17 | $5.37 |
Molina Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | None | $2.82 | $2.82 | $2.82 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $3.16 Median $5.01 Typical High $239.88 | Facility | None | $3.16 | $5.01 | $239.88 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $3.98 Median $5.01 Typical High $281.84 | Professional | None | $3.98 | $5.01 | $281.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $4.17 | Professional | None | $2.82 | $2.82 | $4.17 |
Select Health Setting Facility Modifier None Typical Low $3.98 Median $3.98 Typical High $5.13 | Facility | None | $3.98 | $3.98 | $5.13 |
Select Health Setting Professional Modifier None Typical Low $2.63 Median $3.98 Typical High $4.37 | Professional | None | $2.63 | $3.98 | $4.37 |
United Setting Professional Modifier None Typical Low $1.82 Median $1.95 Typical High $3.02 | Professional | None | $1.82 | $1.95 | $3.02 |
5 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 $0.33 Median $0.79 Typical High $0.79 | Professional | 55 · Aftercare only | $0.33 | $0.79 | $0.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.54 Typical High $0.54 | Professional | 56 · Pre-op care only | $0.22 | $0.54 | $0.54 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2.63 Median $2.95 Typical High $3.09 | Professional | 78 · Unplanned return to OR | $2.63 | $2.95 | $3.09 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.33 Median $0.79 Typical High $0.79 | Professional | 55 · Aftercare only | $0.33 | $0.79 | $0.79 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.54 Typical High $0.54 | Professional | 56 · Pre-op care only | $0.22 | $0.54 | $0.54 |
Where Idaho sits
The same service costs 2.5 times more in Hawaii than in Vermont. 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· 8th of 51
$3.98
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.