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 $467.74 Median $602.56 Typical High $602.56 | Professional | None | $467.74 | $602.56 | $602.56 |
BCBS Idaho Setting Facility Modifier None Typical Low $575.44 Median $691.83 Typical High $1,148.15 | Facility | None | $575.44 | $691.83 | $1,148.15 |
BCBS Idaho Setting Professional Modifier None Typical Low $512.86 Median $758.58 Typical High $812.83 | Professional | None | $512.86 | $758.58 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $588.84 | Facility | None | $562.34 | $562.34 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $562.34 | Professional | None | $407.38 | $407.38 | $562.34 |
Moda Health Setting Facility Modifier None Typical Low $213.80 Median $602.56 Typical High $776.25 | Facility | None | $213.80 | $602.56 | $776.25 |
Moda Health Setting Professional Modifier None Typical Low $467.74 Median $660.69 Typical High $758.58 | Professional | None | $467.74 | $660.69 | $758.58 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $524.81 Typical High $616.60 | Professional | None | $30.20 | $524.81 | $616.60 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $588.84 Median $912.01 Typical High $43,651.58 | Facility | None | $588.84 | $912.01 | $43,651.58 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $724.44 Median $912.01 Typical High $51,286.14 | Professional | None | $724.44 | $912.01 | $51,286.14 |
Regence BlueShield Setting Facility Modifier None Typical Low $676.08 Median $691.83 Typical High $1,047.13 | Facility | None | $676.08 | $691.83 | $1,047.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $758.58 | Professional | None | $512.86 | $512.86 | $758.58 |
Select Health Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $933.25 | Facility | None | $724.44 | $724.44 | $933.25 |
Select Health Setting Professional Modifier None Typical Low $478.63 Median $724.44 Typical High $794.33 | Professional | None | $478.63 | $724.44 | $794.33 |
United Setting Professional Modifier None Typical Low $309.03 Median $331.13 Typical High $512.86 | Professional | None | $309.03 | $331.13 | $512.86 |
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 $69.18 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $69.18 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $60.26 Typical High $60.26 | Professional | 56 · Pre-op care only | $46.77 | $60.26 | $60.26 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $537.03 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $478.63 | $537.03 | $562.34 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $69.18 | $91.20 | $91.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $60.26 Typical High $60.26 | Professional | 56 · Pre-op care only | $46.77 | $60.26 | $60.26 |
Where Idaho sits
The same service costs 2.6 times more in Hawaii than in New Jersey. 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· 13th of 51
$617
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.