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 $7.94 Median $19.05 Typical High $19.05 | Professional | None | $7.94 | $19.05 | $19.05 |
BCBS Idaho Setting Facility Modifier None Typical Low $8.91 Median $13.49 Typical High $22.91 | Facility | None | $8.91 | $13.49 | $22.91 |
BCBS Idaho Setting Professional Modifier None Typical Low $10.00 Median $15.14 Typical High $15.85 | Professional | None | $10.00 | $15.14 | $15.85 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $9.55 Median $10.72 Typical High $11.22 | Professional | 78 · Unplanned return to OR | $9.55 | $10.72 | $11.22 |
Cigna Setting Facility Modifier None Typical Low $10.00 Median $10.00 Typical High $10.47 | Facility | None | $10.00 | $10.00 | $10.47 |
Cigna Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $10.00 | Professional | None | $8.51 | $8.51 | $10.00 |
Moda Health Setting Facility Modifier None Typical Low $4.57 Median $14.45 Typical High $19.05 | Facility | None | $4.57 | $14.45 | $19.05 |
Moda Health Setting Professional Modifier None Typical Low $11.22 Median $15.14 Typical High $19.05 | Professional | None | $11.22 | $15.14 | $19.05 |
Molina Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | None | $10.00 | $10.00 | $10.00 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $11.48 Median $18.20 Typical High $870.96 | Facility | None | $11.48 | $18.20 | $870.96 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $15.14 Median $18.20 Typical High $1,023.29 | Professional | None | $15.14 | $18.20 | $1,023.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $15.14 | Professional | None | $10.00 | $10.00 | $15.14 |
Select Health Setting Facility Modifier None Typical Low $14.45 Median $14.45 Typical High $18.62 | Facility | None | $14.45 | $14.45 | $18.62 |
Select Health Setting Professional Modifier None Typical Low $9.33 Median $14.45 Typical High $15.85 | Professional | None | $9.33 | $14.45 | $15.85 |
United Setting Professional Modifier None Typical Low $6.46 Median $7.08 Typical High $10.96 | Professional | None | $6.46 | $7.08 | $10.96 |
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 $1.20 Median $2.88 Typical High $2.88 | Professional | 55 · Aftercare only | $1.20 | $2.88 | $2.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.79 Median $1.95 Typical High $1.95 | Professional | 56 · Pre-op care only | $0.79 | $1.95 | $1.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.20 Median $2.88 Typical High $2.88 | Professional | 55 · Aftercare only | $1.20 | $2.88 | $2.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.79 Median $1.95 Typical High $1.95 | Professional | 56 · Pre-op care only | $0.79 | $1.95 | $1.95 |
Where Idaho sits
The same service costs 2.3 times more in Montana 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· 6th of 51
$15.14
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.