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 $95.50 Median $123.03 Typical High $123.03 | Professional | None | $95.50 | $123.03 | $123.03 |
BCBS Idaho Setting Facility Modifier None Typical Low $117.49 Median $144.54 Typical High $245.47 | Facility | None | $117.49 | $144.54 | $245.47 |
BCBS Idaho Setting Professional Modifier None Typical Low $104.71 Median $158.49 Typical High $165.96 | Professional | None | $104.71 | $158.49 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $102.33 | Facility | None | $97.72 | $97.72 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $97.72 | Professional | None | $72.44 | $72.44 | $97.72 |
Moda Health Setting Facility Modifier None Typical Low $43.65 Median $123.03 Typical High $151.36 | Facility | None | $43.65 | $123.03 | $151.36 |
Moda Health Setting Professional Modifier None Typical Low $95.50 Median $134.90 Typical High $158.49 | Professional | None | $95.50 | $134.90 | $158.49 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $109.65 Typical High $128.82 | Professional | None | $30.20 | $109.65 | $128.82 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $120.23 Median $190.55 Typical High $9,120.11 | Facility | None | $120.23 | $190.55 | $9,120.11 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $151.36 Median $190.55 Typical High $10,715.19 | Professional | None | $151.36 | $190.55 | $10,715.19 |
Regence BlueShield Setting Facility Modifier None Typical Low $141.25 Median $144.54 Typical High $218.78 | Facility | None | $141.25 | $144.54 | $218.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $158.49 | Professional | None | $104.71 | $104.71 | $158.49 |
Select Health Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $194.98 | Facility | None | $151.36 | $151.36 | $194.98 |
Select Health Setting Professional Modifier None Typical Low $97.72 Median $151.36 Typical High $165.96 | Professional | None | $97.72 | $151.36 | $165.96 |
United Setting Professional Modifier None Typical Low $63.10 Median $67.61 Typical High $114.82 | Professional | None | $63.10 | $67.61 | $114.82 |
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 $14.45 Median $18.62 Typical High $18.62 | Professional | 55 · Aftercare only | $14.45 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $12.30 Typical High $12.30 | Professional | 56 · Pre-op care only | $9.55 | $12.30 | $12.30 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $109.65 Typical High $114.82 | Professional | 78 · Unplanned return to OR | $97.72 | $109.65 | $114.82 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $18.62 Typical High $18.62 | Professional | 55 · Aftercare only | $14.45 | $18.62 | $18.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $12.30 Typical High $12.30 | Professional | 56 · Pre-op care only | $9.55 | $12.30 | $12.30 |
Where Idaho sits
The same service costs 4.2 times more in Kansas than in Delaware. 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· 14th of 51
$129
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.