How much rates vary
Facilitymedian $372 · 10th to 90th $39 to $1,023Professionalmedian $40 · 10th to 90th $29 to $63
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 $1,412.54 Median $4,466.84 Typical High $7,079.46 | Facility | None | $1,412.54 | $4,466.84 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $22.91 Median $63.10 Typical High $63.10 | Professional | None | $22.91 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $18.62 Median $47.86 Typical High $47.86 | Professional | 54 · Surgery only | $18.62 | $47.86 | $47.86 |
BCBS Idaho Setting Facility Modifier None Typical Low $61.66 Median $489.78 Typical High $977.24 | Facility | None | $61.66 | $489.78 | $977.24 |
BCBS Idaho Setting Professional Modifier None Typical Low $36.31 Median $41.69 Typical High $43.65 | Professional | None | $36.31 | $41.69 | $43.65 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $37.15 Typical High $39.81 | Professional | 54 · Surgery only | $32.36 | $37.15 | $39.81 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $31.62 Typical High $36.31 | Professional | None | $26.92 | $31.62 | $36.31 |
Moda Health Setting Facility Modifier None Typical Low $18.62 Median $63.10 Typical High $5,495.41 | Facility | None | $18.62 | $63.10 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $28.84 Median $40.74 Typical High $63.10 | Professional | None | $28.84 | $40.74 | $63.10 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $21.88 Median $47.86 Typical High $47.86 | Professional | 54 · Surgery only | $21.88 | $47.86 | $47.86 |
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 $31.62 Median $38.90 Typical High $38.90 | Facility | None | $31.62 | $38.90 | $38.90 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $41.69 | Professional | None | $38.90 | $38.90 | $41.69 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | 54 · Surgery only | $28.84 | $28.84 | $28.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $512.86 Median $741.31 Typical High $1,023.29 | Facility | None | $512.86 | $741.31 | $1,023.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $36.31 Median $42.66 Typical High $42.66 | Professional | None | $36.31 | $42.66 | $42.66 |
Select Health Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $19.95 | Facility | None | $18.62 | $18.62 | $19.95 |
Select Health Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $39.81 | Professional | None | $18.62 | $18.62 | $39.81 |
United Setting Facility Modifier None Typical Low $144.54 Median $363.08 Typical High $501.19 | Facility | None | $144.54 | $363.08 | $501.19 |
United Setting Professional Modifier None Typical Low $22.39 Median $30.20 Typical High $44.67 | Professional | None | $22.39 | $30.20 | $44.67 |
11 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 $3.63 Median $4.17 Typical High $4.37 | Professional | 55 · Aftercare only | $3.63 | $4.17 | $4.37 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $43.65 Median $50.12 Typical High $52.48 | Professional | 63 · Small infant | $43.65 | $50.12 | $52.48 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $25.12 Median $28.84 Typical High $30.90 | Professional | 78 · Unplanned return to OR | $25.12 | $28.84 | $30.90 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $5.75 Median $6.61 Typical High $7.08 | Professional | 80 · Assistant surgeon | $5.75 | $6.61 | $7.08 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $5.75 Median $6.61 Typical High $7.08 | Professional | 81 · Minimal assistant surgeon | $5.75 | $6.61 | $7.08 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $5.75 Median $6.61 Typical High $7.08 | Professional | 82 · Assistant surgeon, no resident | $5.75 | $6.61 | $7.08 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $4.90 Median $5.62 Typical High $6.03 | Professional | AS · PA/NP assist | $4.90 | $5.62 | $6.03 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | 22 · Increased work | $45.71 | $45.71 | $45.71 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.17 Typical High $4.17 | Professional | 56 · Pre-op care only | $4.17 | $4.17 | $4.17 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | 63 · Small infant | $45.71 | $45.71 | $45.71 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | 78 · Unplanned return to OR | $30.90 | $30.90 | $30.90 |
Where Idaho sits
The same service costs 40.0 times more in New York 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
NY $2,775MT $69.37
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.