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 $97.72 Median $125.89 Typical High $125.89 | Professional | None | $97.72 | $125.89 | $125.89 |
BCBS Idaho Setting Facility Modifier None Typical Low $120.23 Median $147.91 Typical High $251.19 | Facility | None | $120.23 | $147.91 | $251.19 |
BCBS Idaho Setting Professional Modifier None Typical Low $107.15 Median $162.18 Typical High $169.82 | Professional | None | $107.15 | $162.18 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $104.71 | Facility | None | $100.00 | $100.00 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $100.00 | Professional | None | $72.44 | $72.44 | $100.00 |
Moda Health Setting Facility Modifier None Typical Low $44.67 Median $125.89 Typical High $154.88 | Facility | None | $44.67 | $125.89 | $154.88 |
Moda Health Setting Professional Modifier None Typical Low $97.72 Median $125.89 Typical High $162.18 | Professional | None | $97.72 | $125.89 | $162.18 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $109.65 Typical High $131.83 | Professional | None | $30.20 | $109.65 | $131.83 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $123.03 Median $190.55 Typical High $9,332.54 | Facility | None | $123.03 | $190.55 | $9,332.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $162.18 Median $190.55 Typical High $10,715.19 | Professional | None | $162.18 | $190.55 | $10,715.19 |
Regence BlueShield Setting Facility Modifier None Typical Low $144.54 Median $147.91 Typical High $218.78 | Facility | None | $144.54 | $147.91 | $218.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $162.18 | Professional | None | $107.15 | $107.15 | $162.18 |
Select Health Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $199.53 | Facility | None | $154.88 | $154.88 | $199.53 |
Select Health Setting Professional Modifier None Typical Low $100.00 Median $154.88 Typical High $169.82 | Professional | None | $100.00 | $154.88 | $169.82 |
United Setting Professional Modifier None Typical Low $63.10 Median $69.18 Typical High $107.15 | Professional | None | $63.10 | $69.18 | $107.15 |
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 $14.79 Median $19.05 Typical High $19.05 | Professional | 55 · Aftercare only | $14.79 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $9.77 | $12.59 | $12.59 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $112.20 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $100.00 | $112.20 | $117.49 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $19.05 Typical High $19.05 | Professional | 55 · Aftercare only | $14.79 | $19.05 | $19.05 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $9.77 | $12.59 | $12.59 |
Where Idaho sits
The same service costs 2.2 times more in Montana than in Florida. 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· 11th of 51
$132
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.