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 $8.91 Median $21.38 Typical High $21.38 | Professional | None | $8.91 | $21.38 | $21.38 |
BCBS Idaho Setting Facility Modifier None Typical Low $10.96 Median $15.14 Typical High $25.70 | Facility | None | $10.96 | $15.14 | $25.70 |
BCBS Idaho Setting Professional Modifier None Typical Low $11.22 Median $16.98 Typical High $17.78 | Professional | None | $11.22 | $16.98 | $17.78 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $10.47 Median $11.75 Typical High $12.30 | Professional | 78 · Unplanned return to OR | $10.47 | $11.75 | $12.30 |
Cigna Setting Facility Modifier None Typical Low $9.55 Median $9.55 Typical High $10.23 | Facility | None | $9.55 | $9.55 | $10.23 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $9.55 | Professional | None | $8.13 | $8.13 | $9.55 |
Moda Health Setting Facility Modifier None Typical Low $4.37 Median $15.14 Typical High $21.38 | Facility | None | $4.37 | $15.14 | $21.38 |
Moda Health Setting Professional Modifier None Typical Low $11.48 Median $16.98 Typical High $21.38 | Professional | None | $11.48 | $16.98 | $21.38 |
Molina Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $30.20 | Professional | None | $16.98 | $16.98 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $12.59 Median $19.95 Typical High $954.99 | Facility | None | $12.59 | $19.95 | $954.99 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $16.98 Median $19.95 Typical High $1,122.02 | Professional | None | $16.98 | $19.95 | $1,122.02 |
Regence BlueShield Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $16.98 | Professional | None | $11.22 | $11.22 | $16.98 |
Select Health Setting Facility Modifier None Typical Low $16.22 Median $16.22 Typical High $20.42 | Facility | None | $16.22 | $16.22 | $20.42 |
Select Health Setting Professional Modifier None Typical Low $10.47 Median $16.22 Typical High $17.78 | Professional | None | $10.47 | $16.22 | $17.78 |
United Setting Professional Modifier None Typical Low $6.17 Median $6.76 Typical High $10.96 | Professional | None | $6.17 | $6.76 | $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 $1.35 Median $3.24 Typical High $3.24 | Professional | 55 · Aftercare only | $1.35 | $3.24 | $3.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.89 Median $2.14 Typical High $2.14 | Professional | 56 · Pre-op care only | $0.89 | $2.14 | $2.14 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.35 Median $3.24 Typical High $3.24 | Professional | 55 · Aftercare only | $1.35 | $3.24 | $3.24 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.89 Median $2.14 Typical High $2.14 | Professional | 56 · Pre-op care only | $0.89 | $2.14 | $2.14 |
Where Idaho sits
The same service costs 2.2 times more in Kansas 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· 2nd of 51
$16.98
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.