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 $7.08 Median $14.45 Typical High $14.45 | Professional | None | $7.08 | $14.45 | $14.45 |
BCBS Idaho Setting Facility Modifier None Typical Low $7.76 Median $10.47 Typical High $15.85 | Facility | None | $7.76 | $10.47 | $15.85 |
BCBS Idaho Setting Professional Modifier None Typical Low $7.59 Median $11.48 Typical High $12.02 | Professional | None | $7.59 | $11.48 | $12.02 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $7.08 Median $7.94 Typical High $8.32 | Professional | 78 · Unplanned return to OR | $7.08 | $7.94 | $8.32 |
Cigna Setting Facility Modifier None Typical Low $7.59 Median $7.59 Typical High $8.13 | Facility | None | $7.59 | $7.59 | $8.13 |
Cigna Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $7.59 | Professional | None | $6.31 | $6.31 | $7.59 |
Moda Health Setting Facility Modifier None Typical Low $3.39 Median $10.96 Typical High $14.45 | Facility | None | $3.39 | $10.96 | $14.45 |
Moda Health Setting Professional Modifier None Typical Low $8.51 Median $11.48 Typical High $14.45 | Professional | None | $8.51 | $11.48 | $14.45 |
Molina Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | None | $7.59 | $7.59 | $7.59 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $8.71 Median $13.49 Typical High $645.65 | Facility | None | $8.71 | $13.49 | $645.65 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $10.96 Median $13.49 Typical High $758.58 | Professional | None | $10.96 | $13.49 | $758.58 |
Regence BlueShield Setting Facility Modifier None Typical Low $10.00 Median $10.47 Typical High $15.49 | Facility | None | $10.00 | $10.47 | $15.49 |
Regence BlueShield Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $11.48 | Professional | None | $7.59 | $7.59 | $11.48 |
Select Health Setting Facility Modifier None Typical Low $10.96 Median $10.96 Typical High $13.80 | Facility | None | $10.96 | $10.96 | $13.80 |
Select Health Setting Professional Modifier None Typical Low $7.08 Median $10.96 Typical High $11.75 | Professional | None | $7.08 | $10.96 | $11.75 |
United Setting Professional Modifier None Typical Low $4.90 Median $5.25 Typical High $8.32 | Professional | None | $4.90 | $5.25 | $8.32 |
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 $1.07 Median $2.14 Typical High $2.14 | Professional | 55 · Aftercare only | $1.07 | $2.14 | $2.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.71 Median $1.45 Typical High $1.45 | Professional | 56 · Pre-op care only | $0.71 | $1.45 | $1.45 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.07 Median $2.14 Typical High $2.14 | Professional | 55 · Aftercare only | $1.07 | $2.14 | $2.14 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.71 Median $1.45 Typical High $1.45 | Professional | 56 · Pre-op care only | $0.71 | $1.45 | $1.45 |
Where Idaho sits
The same service costs 5.0 times more in Hawaii than in Rhode Island. 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· 7th of 51
$11.22
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.