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 $47.86 Median $63.10 Typical High $63.10 | Professional | None | $47.86 | $63.10 | $63.10 |
BCBS Idaho Setting Facility Modifier None Typical Low $58.88 Median $72.44 Typical High $123.03 | Facility | None | $58.88 | $72.44 | $123.03 |
BCBS Idaho Setting Professional Modifier None Typical Low $53.70 Median $79.43 Typical High $83.18 | Professional | None | $53.70 | $79.43 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $46.77 | Facility | None | $43.65 | $43.65 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $43.65 | Professional | None | $37.15 | $37.15 | $43.65 |
Moda Health Setting Facility Modifier None Typical Low $21.88 Median $63.10 Typical High $75.86 | Facility | None | $21.88 | $63.10 | $75.86 |
Moda Health Setting Professional Modifier None Typical Low $47.86 Median $67.61 Typical High $79.43 | Professional | None | $47.86 | $67.61 | $79.43 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $54.95 Typical High $64.57 | Professional | None | $30.20 | $54.95 | $64.57 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $60.26 Median $95.50 Typical High $4,570.88 | Facility | None | $60.26 | $95.50 | $4,570.88 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $75.86 Median $95.50 Typical High $5,370.32 | Professional | None | $75.86 | $95.50 | $5,370.32 |
Regence BlueShield Setting Facility Modifier None Typical Low $70.79 Median $72.44 Typical High $109.65 | Facility | None | $70.79 | $72.44 | $109.65 |
Regence BlueShield Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $79.43 | Professional | None | $53.70 | $53.70 | $79.43 |
Select Health Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $97.72 | Facility | None | $75.86 | $75.86 | $97.72 |
Select Health Setting Professional Modifier None Typical Low $48.98 Median $75.86 Typical High $83.18 | Professional | None | $48.98 | $75.86 | $83.18 |
United Setting Professional Modifier None Typical Low $31.62 Median $33.88 Typical High $52.48 | Professional | None | $31.62 | $33.88 | $52.48 |
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 $7.24 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $7.24 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $6.31 Typical High $6.31 | Professional | 56 · Pre-op care only | $4.79 | $6.31 | $6.31 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $50.12 Median $56.23 Typical High $58.88 | Professional | 78 · Unplanned return to OR | $50.12 | $56.23 | $58.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $7.24 | $9.33 | $9.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $6.31 Typical High $6.31 | Professional | 56 · Pre-op care only | $4.79 | $6.31 | $6.31 |
Where Idaho sits
The same service costs 2.2 times more in Montana than in West Virginia. 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· 12th of 51
$64.57
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.