How much rates vary
Facilitymedian $1,349 · 10th to 90th $550 to $7,244Professionalmedian $2,818 · 10th to 90th $1,905 to $4,898
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 $1,905.46 Median $4,897.79 Typical High $4,897.79 | Professional | None | $1,905.46 | $4,897.79 | $4,897.79 |
BCBS Idaho Setting Facility Modifier None Typical Low $6,309.57 Median $6,760.83 Typical High $9,772.37 | Facility | None | $6,309.57 | $6,760.83 | $9,772.37 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,570.40 Median $3,019.95 Typical High $3,235.94 | Professional | None | $2,570.40 | $3,019.95 | $3,235.94 |
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 $2,041.74 Median $2,398.83 Typical High $2,754.23 | Professional | None | $2,041.74 | $2,398.83 | $2,754.23 |
Moda Health Setting Facility Modifier None Typical Low $1,348.96 Median $4,897.79 Typical High $7,079.46 | Facility | None | $1,348.96 | $4,897.79 | $7,079.46 |
Moda Health Setting Professional Modifier None Typical Low $2,137.96 Median $3,019.95 Typical High $4,897.79 | Professional | None | $2,137.96 | $3,019.95 | $4,897.79 |
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 $2,290.87 Median $2,818.38 Typical High $2,818.38 | Facility | None | $2,290.87 | $2,818.38 | $2,818.38 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,818.38 | $2,818.38 | $2,818.38 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,019.95 Median $3,235.94 Typical High $3,388.44 | Professional | None | $3,019.95 | $3,235.94 | $3,388.44 |
Select Health Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,479.11 | Facility | None | $1,348.96 | $1,348.96 | $1,479.11 |
Select Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,995.26 | Professional | None | $1,348.96 | $1,348.96 | $1,995.26 |
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 $1,737.80 Median $2,511.89 Typical High $3,630.78 | Professional | None | $1,737.80 | $2,511.89 | $3,630.78 |
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 Professional Modifier 50 · Both sides Typical Low $3,801.89 Median $4,466.84 Typical High $4,786.30 | Professional | 50 · Both sides | $3,801.89 | $4,466.84 | $4,786.30 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,290.87 Median $2,630.27 Typical High $2,884.03 | Professional | 54 · Surgery only | $2,290.87 | $2,630.27 | $2,884.03 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $295.12 Typical High $316.23 | Professional | 55 · Aftercare only | $257.04 | $295.12 | $316.23 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,584.89 Median $1,862.09 Typical High $1,995.26 | Professional | 62 · Two surgeons | $1,584.89 | $1,862.09 | $1,995.26 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $3,090.30 Median $3,548.13 Typical High $3,801.89 | Professional | 63 · Small infant | $3,090.30 | $3,548.13 | $3,801.89 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $2,089.30 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,778.28 | $2,089.30 | $2,238.72 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $407.38 Median $467.74 Typical High $512.86 | Professional | 80 · Assistant surgeon | $407.38 | $467.74 | $512.86 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $407.38 Median $467.74 Typical High $512.86 | Professional | 81 · Minimal assistant surgeon | $407.38 | $467.74 | $512.86 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $407.38 Median $467.74 Typical High $512.86 | Professional | 82 · Assistant surgeon, no resident | $407.38 | $467.74 | $512.86 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $346.74 Median $398.11 Typical High $436.52 | Professional | AS · PA/NP assist | $346.74 | $398.11 | $436.52 |
Where Idaho sits
The same service costs 7.1 times more in Maine than in Washington. 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 $16,524WA $2,342
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.