How much rates vary
Facilitymedian $339 · 10th to 90th $135 to $1,862Professionalmedian $166 · 10th to 90th $129 to $229
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 $1,412.54 Median $4,466.84 Typical High $7,079.46 | Facility | None | $1,412.54 | $4,466.84 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $147.91 Typical High $181.97 | Professional | None | $87.10 | $147.91 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $109.65 Typical High $138.04 | Professional | 54 · Surgery only | $109.65 | $109.65 | $138.04 |
BCBS Idaho Setting Facility Modifier None Typical Low $288.40 Median $758.58 Typical High $2,238.72 | Facility | None | $288.40 | $758.58 | $2,238.72 |
BCBS Idaho Setting Professional Modifier None Typical Low $147.91 Median $181.97 Typical High $263.03 | Professional | None | $147.91 | $181.97 | $263.03 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $151.36 Typical High $251.19 | Professional | 54 · Surgery only | $134.90 | $151.36 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $151.36 Typical High $190.55 | Professional | None | $120.23 | $151.36 | $190.55 |
Moda Health Setting Facility Modifier None Typical Low $117.49 Median $181.97 Typical High $5,495.41 | Facility | None | $117.49 | $181.97 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $141.25 Median $181.97 Typical High $229.09 | Professional | None | $141.25 | $181.97 | $229.09 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $109.65 Typical High $138.04 | Professional | 54 · Surgery only | $109.65 | $109.65 | $138.04 |
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 $131.83 Median $141.25 Typical High $213.80 | Facility | None | $131.83 | $141.25 | $213.80 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $141.25 Median $162.18 Typical High $245.47 | Professional | None | $141.25 | $162.18 | $245.47 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $112.20 Typical High $141.25 | Professional | 54 · Surgery only | $112.20 | $112.20 | $141.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $147.91 Median $181.97 Typical High $229.09 | Professional | None | $147.91 | $181.97 | $229.09 |
Select Health Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $123.03 | Facility | None | $117.49 | $117.49 | $123.03 |
Select Health Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $151.36 | Professional | None | $117.49 | $117.49 | $151.36 |
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 $102.33 Median $147.91 Typical High $208.93 | Professional | None | $102.33 | $147.91 | $208.93 |
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 $14.79 Median $19.05 Typical High $27.54 | Professional | 55 · Aftercare only | $14.79 | $19.05 | $27.54 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $173.78 Median $213.80 Typical High $331.13 | Professional | 63 · Small infant | $173.78 | $213.80 | $331.13 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $123.03 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $104.71 | $123.03 | $194.98 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $23.99 Median $29.51 Typical High $38.02 | Professional | 80 · Assistant surgeon | $23.99 | $29.51 | $38.02 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $22.91 Median $28.18 Typical High $40.74 | Professional | 81 · Minimal assistant surgeon | $22.91 | $28.18 | $40.74 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $25.70 Median $28.18 Typical High $38.02 | Professional | 82 · Assistant surgeon, no resident | $25.70 | $28.18 | $38.02 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $21.88 Median $25.12 Typical High $34.67 | Professional | AS · PA/NP assist | $21.88 | $25.12 | $34.67 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.22 Typical High $20.42 | Professional | 56 · Pre-op care only | $16.22 | $16.22 | $20.42 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $120.23 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $120.23 | $120.23 | $151.36 |
Where Idaho sits
The same service costs 18.1 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 $3,577KY $198
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.