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 $9.77 Median $20.89 Typical High $20.89 | Professional | None | $9.77 | $20.89 | $20.89 |
BCBS Idaho Setting Facility Modifier None Typical Low $11.22 Median $14.79 Typical High $24.55 | Facility | None | $11.22 | $14.79 | $24.55 |
BCBS Idaho Setting Professional Modifier None Typical Low $10.96 Median $16.22 Typical High $16.98 | Professional | None | $10.96 | $16.22 | $16.98 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $10.23 Median $11.48 Typical High $12.02 | Professional | 78 · Unplanned return to OR | $10.23 | $11.48 | $12.02 |
Cigna Setting Facility Modifier None Typical Low $10.72 Median $10.72 Typical High $11.48 | Facility | None | $10.72 | $10.72 | $11.48 |
Cigna Setting Professional Modifier None Typical Low $9.12 Median $9.12 Typical High $10.72 | Professional | None | $9.12 | $9.12 | $10.72 |
Moda Health Setting Facility Modifier None Typical Low $4.90 Median $14.79 Typical High $20.89 | Facility | None | $4.90 | $14.79 | $20.89 |
Moda Health Setting Professional Modifier None Typical Low $11.22 Median $16.22 Typical High $20.89 | Professional | None | $11.22 | $16.22 | $20.89 |
Molina Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | None | $10.72 | $10.72 | $10.72 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $12.30 Median $19.50 Typical High $933.25 | Facility | None | $12.30 | $19.50 | $933.25 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $15.49 Median $19.50 Typical High $1,096.48 | Professional | None | $15.49 | $19.50 | $1,096.48 |
Regence BlueShield Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $16.22 | Professional | None | $10.96 | $10.96 | $16.22 |
Select Health Setting Facility Modifier None Typical Low $15.49 Median $15.49 Typical High $19.95 | Facility | None | $15.49 | $15.49 | $19.95 |
Select Health Setting Professional Modifier None Typical Low $10.00 Median $15.49 Typical High $16.98 | Professional | None | $10.00 | $15.49 | $16.98 |
United Setting Professional Modifier None Typical Low $6.92 Median $7.59 Typical High $11.75 | Professional | None | $6.92 | $7.59 | $11.75 |
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 $1.45 Median $3.09 Typical High $3.09 | Professional | 55 · Aftercare only | $1.45 | $3.09 | $3.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.98 Median $2.04 Typical High $2.04 | Professional | 56 · Pre-op care only | $0.98 | $2.04 | $2.04 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.45 Median $3.09 Typical High $3.09 | Professional | 55 · Aftercare only | $1.45 | $3.09 | $3.09 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.98 Median $2.09 Typical High $2.09 | Professional | 56 · Pre-op care only | $0.98 | $2.09 | $2.09 |
Where Idaho sits
The same service costs 2.9 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· 8th of 51
$16.22
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.