How much rates vary
Facilitymedian $1,585 · 10th to 90th $708 to $6,607Professionalmedian $708 · 10th to 90th $479 to $1,000
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 $501.19 Median $851.14 Typical High $7,079.46 | Facility | None | $501.19 | $851.14 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $707.95 Typical High $1,000.00 | Professional | None | $436.52 | $707.95 | $1,000.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $537.03 Typical High $758.58 | Professional | 54 · Surgery only | $331.13 | $537.03 | $758.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $501.19 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $309.03 | $501.19 | $707.95 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,659.59 Median $2,290.87 Typical High $7,413.10 | Facility | None | $1,659.59 | $2,290.87 | $7,413.10 |
BCBS Idaho Setting Professional Modifier None Typical Low $575.44 Median $758.58 Typical High $1,023.29 | Professional | None | $575.44 | $758.58 | $1,023.29 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $645.65 Typical High $912.01 | Professional | 54 · Surgery only | $512.86 | $645.65 | $912.01 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $467.74 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $416.87 | $467.74 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $1,548.82 Typical High $2,089.30 | Facility | None | $1,380.38 | $1,548.82 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $549.54 Typical High $794.33 | Professional | None | $457.09 | $549.54 | $794.33 |
Moda Health Setting Facility Modifier None Typical Low $446.68 Median $758.58 Typical High $4,466.84 | Facility | None | $446.68 | $758.58 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $512.86 Median $794.33 Typical High $1,000.00 | Professional | None | $512.86 | $794.33 | $1,000.00 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $537.03 Typical High $758.58 | Professional | 54 · Surgery only | $331.13 | $537.03 | $758.58 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $501.19 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $309.03 | $501.19 | $707.95 |
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 $616.60 Median $616.60 Typical High $933.25 | Facility | None | $616.60 | $616.60 | $933.25 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $1,174.90 | Professional | None | $616.60 | $776.25 | $1,174.90 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $741.31 | Professional | 54 · Surgery only | $537.03 | $537.03 | $741.31 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $794.33 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,570.88 Median $6,606.93 Typical High $9,332.54 | Facility | None | $4,570.88 | $6,606.93 | $9,332.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $676.08 Median $831.76 Typical High $1,148.15 | Professional | None | $676.08 | $831.76 | $1,148.15 |
Select Health Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $457.09 | Facility | None | $446.68 | $446.68 | $457.09 |
Select Health Setting Professional Modifier None Typical Low $346.74 Median $446.68 Typical High $1,412.54 | Professional | None | $346.74 | $446.68 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,621.81 | Facility | None | $1,047.13 | $1,412.54 | $1,621.81 |
United Setting Professional Modifier None Typical Low $380.19 Median $588.84 Typical High $954.99 | Professional | None | $380.19 | $588.84 | $954.99 |
10 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 Facility Modifier 50 · Both sides Typical Low $2,511.89 Median $3,388.44 Typical High $11,220.18 | Facility | 50 · Both sides | $2,511.89 | $3,388.44 | $11,220.18 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $851.14 Median $1,258.93 Typical High $1,513.56 | Professional | 50 · Both sides | $851.14 | $1,258.93 | $1,513.56 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $69.18 Typical High $102.33 | Professional | 55 · Aftercare only | $57.54 | $69.18 | $102.33 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $691.83 Median $1,023.29 Typical High $1,202.26 | Professional | 63 · Small infant | $691.83 | $1,023.29 | $1,202.26 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $123.03 Typical High $154.88 | Professional | 80 · Assistant surgeon | $102.33 | $123.03 | $154.88 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $91.20 Median $112.20 Typical High $165.96 | Professional | 81 · Minimal assistant surgeon | $91.20 | $112.20 | $165.96 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $91.20 Median $114.82 Typical High $165.96 | Professional | 82 · Assistant surgeon, no resident | $91.20 | $114.82 | $165.96 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $77.62 Median $117.49 Typical High $138.04 | Professional | AS · PA/NP assist | $77.62 | $117.49 | $138.04 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $1,148.15 Median $1,148.15 Typical High $1,584.89 | Professional | 50 · Both sides | $1,148.15 | $1,148.15 | $1,584.89 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $107.15 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $107.15 |
Where Idaho sits
The same service costs 6.0 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 $6,136WV $1,026
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.