How much rates vary
Facilitymedian $251 · 10th to 90th $79 to $741Professionalmedian $98 · 10th to 90th $72 to $138
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 $100.00 Median $131.83 Typical High $5,495.41 | Facility | None | $100.00 | $131.83 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $83.18 Typical High $112.20 | Professional | None | $51.29 | $83.18 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $63.10 Typical High $83.18 | Professional | 54 · Surgery only | $63.10 | $63.10 | $83.18 |
BCBS Idaho Setting Facility Modifier None Typical Low $162.18 Median $295.12 Typical High $741.31 | Facility | None | $162.18 | $295.12 | $741.31 |
BCBS Idaho Setting Professional Modifier None Typical Low $83.18 Median $102.33 Typical High $158.49 | Professional | None | $83.18 | $102.33 | $158.49 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $102.33 Typical High $147.91 | Professional | 54 · Surgery only | $74.13 | $102.33 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $87.10 Typical High $114.82 | Professional | None | $69.18 | $87.10 | $114.82 |
Moda Health Setting Facility Modifier None Typical Low $70.79 Median $120.23 Typical High $4,466.84 | Facility | None | $70.79 | $120.23 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $79.43 Median $104.71 Typical High $138.04 | Professional | None | $79.43 | $104.71 | $138.04 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $63.10 Typical High $83.18 | Professional | 54 · Surgery only | $63.10 | $63.10 | $83.18 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $74.13 Median $79.43 Typical High $125.89 | Facility | None | $74.13 | $79.43 | $125.89 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $79.43 Median $93.33 Typical High $147.91 | Professional | None | $79.43 | $93.33 | $147.91 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $64.57 Typical High $85.11 | Professional | 54 · Surgery only | $64.57 | $64.57 | $85.11 |
Regence BlueShield Setting Professional Modifier None Typical Low $83.18 Median $104.71 Typical High $138.04 | Professional | None | $83.18 | $104.71 | $138.04 |
Select Health Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $501.19 | Facility | None | $70.79 | $70.79 | $501.19 |
Select Health Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $91.20 | Professional | None | $70.79 | $70.79 | $91.20 |
United Setting Facility Modifier None Typical Low $144.54 Median $363.08 Typical High $501.19 | Facility | None | $144.54 | $363.08 | $501.19 |
United Setting Professional Modifier None Typical Low $60.26 Median $83.18 Typical High $123.03 | Professional | None | $60.26 | $83.18 | $123.03 |
9 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 |
|---|---|---|---|---|---|
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $10.00 Typical High $15.14 | Professional | 55 · Aftercare only | $8.51 | $10.00 | $15.14 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $102.33 Median $147.91 Typical High $199.53 | Professional | 63 · Small infant | $102.33 | $147.91 | $199.53 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $58.88 Median $69.18 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $58.88 | $69.18 | $107.15 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $14.13 Median $18.20 Typical High $25.70 | Professional | 80 · Assistant surgeon | $14.13 | $18.20 | $25.70 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $14.13 Median $15.85 Typical High $26.30 | Professional | 81 · Minimal assistant surgeon | $14.13 | $15.85 | $26.30 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $15.14 Median $19.50 Typical High $26.30 | Professional | 82 · Assistant surgeon, no resident | $15.14 | $19.50 | $26.30 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $11.22 Median $13.49 Typical High $22.39 | Professional | AS · PA/NP assist | $11.22 | $13.49 | $22.39 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $12.30 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $12.30 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $69.18 Typical High $91.20 | Professional | 78 · Unplanned return to OR | $69.18 | $69.18 | $91.20 |
Where Idaho sits
The same service costs 21.7 times more in New York than in Kentucky. 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.
Physician feeFacility fee
NY $2,952KY $136
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.