How much rates vary
Facilitymedian $676 · 10th to 90th $363 to $4,677Professionalmedian $417 · 10th to 90th $302 to $661
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 $398.11 Median $630.96 Typical High $5,495.41 | Facility | None | $398.11 | $630.96 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $331.13 Typical High $524.81 | Professional | None | $223.87 | $331.13 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $257.04 Typical High $398.11 | Professional | 54 · Surgery only | $251.19 | $257.04 | $398.11 |
BCBS Idaho Setting Facility Modifier None Typical Low $371.54 Median $1,380.38 Typical High $4,786.30 | Facility | None | $371.54 | $1,380.38 | $4,786.30 |
BCBS Idaho Setting Professional Modifier None Typical Low $331.13 Median $446.68 Typical High $758.58 | Professional | None | $331.13 | $446.68 | $758.58 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $371.54 Typical High $512.86 | Professional | 54 · Surgery only | $316.23 | $371.54 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $501.19 Typical High $707.95 | Facility | None | $446.68 | $501.19 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $549.54 | Professional | None | $281.84 | $389.05 | $549.54 |
Moda Health Setting Facility Modifier None Typical Low $331.13 Median $630.96 Typical High $4,466.84 | Facility | None | $331.13 | $630.96 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $323.59 Median $416.87 Typical High $660.69 | Professional | None | $323.59 | $416.87 | $660.69 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $251.19 Typical High $398.11 | Professional | 54 · Surgery only | $251.19 | $251.19 | $398.11 |
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 $309.03 Median $323.59 Typical High $602.56 | Facility | None | $309.03 | $323.59 | $602.56 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $323.59 Median $416.87 Typical High $707.95 | Professional | None | $323.59 | $416.87 | $707.95 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $257.04 Typical High $407.38 | Professional | 54 · Surgery only | $257.04 | $257.04 | $407.38 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,311.31 Median $4,677.35 Typical High $6,025.60 | Facility | None | $3,311.31 | $4,677.35 | $6,025.60 |
Regence BlueShield Setting Professional Modifier None Typical Low $331.13 Median $426.58 Typical High $660.69 | Professional | None | $331.13 | $426.58 | $660.69 |
Select Health Setting Facility Modifier None Typical Low $331.13 Median $338.84 Typical High $1,047.13 | Facility | None | $331.13 | $338.84 | $1,047.13 |
Select Health Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $426.58 | Professional | None | $331.13 | $331.13 | $426.58 |
United Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $954.99 | Facility | None | $549.54 | $676.08 | $954.99 |
United Setting Professional Modifier None Typical Low $245.47 Median $371.54 Typical High $588.84 | Professional | None | $245.47 | $371.54 | $588.84 |
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 $33.88 Median $41.69 Typical High $72.44 | Professional | 55 · Aftercare only | $33.88 | $41.69 | $72.44 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $407.38 Median $489.78 Typical High $870.96 | Professional | 63 · Small infant | $407.38 | $489.78 | $870.96 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $288.40 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $245.47 | $288.40 | $501.19 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $56.23 Median $66.07 Typical High $125.89 | Professional | 80 · Assistant surgeon | $56.23 | $66.07 | $125.89 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $57.54 Median $91.20 Typical High $125.89 | Professional | 81 · Minimal assistant surgeon | $57.54 | $91.20 | $125.89 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $56.23 Median $67.61 Typical High $107.15 | Professional | 82 · Assistant surgeon, no resident | $56.23 | $67.61 | $107.15 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $48.98 Median $72.44 Typical High $97.72 | Professional | AS · PA/NP assist | $48.98 | $72.44 | $97.72 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $57.54 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $57.54 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $275.42 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $275.42 | $275.42 | $436.52 |
Where Idaho sits
The same service costs 6.7 times more in Colorado 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.
Physician feeFacility fee
CO $4,532WV $678
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.