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 Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $269.15 | Facility | None | $199.53 | $199.53 | $269.15 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $223.87 Typical High $223.87 | Professional | None | $162.18 | $223.87 | $223.87 |
BCBS Idaho Setting Facility Modifier None Typical Low $229.09 Median $380.19 Typical High $1,230.27 | Facility | None | $229.09 | $380.19 | $1,230.27 |
BCBS Idaho Setting Professional Modifier None Typical Low $190.55 Median $288.40 Typical High $302.00 | Professional | None | $190.55 | $288.40 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $204.17 | Facility | None | $194.98 | $194.98 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $194.98 | Professional | None | $165.96 | $165.96 | $194.98 |
Moda Health Setting Facility Modifier None Typical Low $75.86 Median $223.87 Typical High $2,884.03 | Facility | None | $75.86 | $223.87 | $2,884.03 |
Moda Health Setting Professional Modifier None Typical Low $173.78 Median $257.04 Typical High $288.40 | Professional | None | $173.78 | $257.04 | $288.40 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $194.98 Typical High $229.09 | Professional | None | $30.20 | $194.98 | $229.09 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $213.80 Median $338.84 Typical High $16,595.87 | Facility | None | $213.80 | $338.84 | $16,595.87 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $275.42 Median $338.84 Typical High $19,054.61 | Professional | None | $275.42 | $338.84 | $19,054.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $288.40 | Professional | None | $190.55 | $190.55 | $288.40 |
Select Health Setting Facility Modifier None Typical Low $269.15 Median $275.42 Typical High $281.84 | Facility | None | $269.15 | $275.42 | $281.84 |
Select Health Setting Professional Modifier None Typical Low $177.83 Median $275.42 Typical High $302.00 | Professional | None | $177.83 | $275.42 | $302.00 |
United Setting Professional Modifier None Typical Low $109.65 Median $117.49 Typical High $181.97 | Professional | None | $109.65 | $117.49 | $181.97 |
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 $26.30 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $26.30 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $22.39 Typical High $22.39 | Professional | 56 · Pre-op care only | $17.38 | $22.39 | $22.39 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $199.53 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $177.83 | $199.53 | $208.93 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $26.30 | $33.88 | $33.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $22.39 Typical High $22.39 | Professional | 56 · Pre-op care only | $17.38 | $22.39 | $22.39 |
Where Idaho sits
The same service costs 2.6 times more in Montana than in New York. 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
$224
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.