How much rates vary
Facilitymedian $631 · 10th to 90th $151 to $1,862Professionalmedian $219 · 10th to 90th $138 to $389
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 $4,466.84 Median $4,466.84 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $173.78 Typical High $389.05 | Professional | None | $123.03 | $173.78 | $389.05 |
BCBS Idaho Setting Professional Modifier None Typical Low $199.53 Median $234.42 Typical High $251.19 | Professional | None | $199.53 | $234.42 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $1,380.38 Typical High $12,589.25 | Facility | None | $151.36 | $1,380.38 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $204.17 Typical High $223.87 | Professional | None | $162.18 | $204.17 | $223.87 |
Moda Health Setting Facility Modifier None Typical Low $104.71 Median $389.05 Typical High $5,495.41 | Facility | None | $104.71 | $389.05 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $131.83 Median $234.42 Typical High $389.05 | Professional | None | $131.83 | $234.42 | $389.05 |
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 $181.97 Median $218.78 Typical High $218.78 | Facility | None | $181.97 | $218.78 | $218.78 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $223.87 | Professional | None | $218.78 | $218.78 | $223.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $239.88 Median $251.19 Typical High $269.15 | Professional | None | $239.88 | $251.19 | $269.15 |
Select Health Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $114.82 | Facility | None | $104.71 | $104.71 | $114.82 |
Select Health Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $158.49 | Professional | None | $104.71 | $104.71 | $158.49 |
United Setting Facility Modifier None Typical Low $436.52 Median $676.08 Typical High $870.96 | Facility | None | $436.52 | $676.08 | $870.96 |
United Setting Professional Modifier None Typical Low $138.04 Median $190.55 Typical High $281.84 | Professional | None | $138.04 | $190.55 | $281.84 |
8 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 54 · Surgery only Typical Low $177.83 Median $208.93 Typical High $223.87 | Professional | 54 · Surgery only | $177.83 | $208.93 | $223.87 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $22.91 Typical High $24.55 | Professional | 55 · Aftercare only | $19.95 | $22.91 | $24.55 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $239.88 Median $275.42 Typical High $295.12 | Professional | 63 · Small infant | $239.88 | $275.42 | $295.12 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $162.18 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $138.04 | $162.18 | $173.78 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $31.62 Median $37.15 Typical High $39.81 | Professional | 80 · Assistant surgeon | $31.62 | $37.15 | $39.81 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $31.62 Median $37.15 Typical High $39.81 | Professional | 81 · Minimal assistant surgeon | $31.62 | $37.15 | $39.81 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $31.62 Median $37.15 Typical High $39.81 | Professional | 82 · Assistant surgeon, no resident | $31.62 | $37.15 | $39.81 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $26.92 Median $31.62 Typical High $33.88 | Professional | AS · PA/NP assist | $26.92 | $31.62 | $33.88 |
Where Idaho sits
The same service costs 262.6 times more in Maine than in Montana. 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
ME $102,516MT $390
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.