How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,622 to $13,183Professionalmedian $1,622 · 10th to 90th $1,047 to $2,818
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 $4,786.30 Typical High $6,918.31 | Facility | None | $4,466.84 | $4,786.30 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $2,818.38 Typical High $2,818.38 | Professional | None | $912.01 | $2,818.38 | $2,818.38 |
BCBS Idaho Setting Facility Modifier None Typical Low $4,168.69 Median $7,079.46 Typical High $14,454.40 | Facility | None | $4,168.69 | $7,079.46 | $14,454.40 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,479.11 Median $1,737.80 Typical High $1,819.70 | Professional | None | $1,479.11 | $1,737.80 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $3,467.37 Median $3,890.45 Typical High $5,370.32 | Facility | None | $3,467.37 | $3,890.45 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $1,548.82 | Professional | None | $1,148.15 | $1,348.96 | $1,548.82 |
Moda Health Setting Facility Modifier None Typical Low $1,096.48 Median $2,818.38 Typical High $5,495.41 | Facility | None | $1,096.48 | $2,818.38 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,737.80 Typical High $2,818.38 | Professional | None | $1,202.26 | $1,737.80 | $2,818.38 |
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 $1,318.26 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,318.26 | $1,621.81 | $1,621.81 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $8,511.38 | Professional | None | $1,621.81 | $1,621.81 | $8,511.38 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,332.54 Median $13,182.57 Typical High $17,782.79 | Facility | None | $9,332.54 | $13,182.57 | $17,782.79 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,737.80 Median $1,819.70 Typical High $1,949.84 | Professional | None | $1,737.80 | $1,819.70 | $1,949.84 |
Select Health Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $10,715.19 | Facility | None | $776.25 | $776.25 | $10,715.19 |
Select Health Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,148.15 | Professional | None | $776.25 | $776.25 | $1,148.15 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,818.38 Typical High $4,265.80 | Facility | None | $1,288.25 | $2,818.38 | $4,265.80 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,412.54 Typical High $2,041.74 | Professional | None | $977.24 | $1,412.54 | $2,041.74 |
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 54 · Surgery only Typical Low $1,318.26 Median $1,513.56 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,318.26 | $1,513.56 | $1,621.81 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $165.96 Typical High $181.97 | Professional | 55 · Aftercare only | $144.54 | $165.96 | $181.97 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $912.01 Median $1,047.13 Typical High $1,122.02 | Professional | 62 · Two surgeons | $912.01 | $1,047.13 | $1,122.02 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,737.80 Median $1,995.26 Typical High $2,187.76 | Professional | 63 · Small infant | $1,737.80 | $1,995.26 | $2,187.76 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,174.90 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,174.90 | $1,258.93 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $269.15 Typical High $288.40 | Professional | 80 · Assistant surgeon | $234.42 | $269.15 | $288.40 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $234.42 Median $269.15 Typical High $288.40 | Professional | 81 · Minimal assistant surgeon | $234.42 | $269.15 | $288.40 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $234.42 Median $269.15 Typical High $288.40 | Professional | 82 · Assistant surgeon, no resident | $234.42 | $269.15 | $288.40 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $229.09 Typical High $245.47 | Professional | AS · PA/NP assist | $199.53 | $229.09 | $245.47 |
Where Idaho sits
The same service costs 4.0 times more in Wisconsin 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
WI $11,674MT $2,925
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.