How much rates vary
Facilitymedian $6,310 · 10th to 90th $1,413 to $24,547Professionalmedian $1,318 · 10th to 90th $933 to $1,660
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 $1,737.80 Median $4,365.16 Typical High $8,511.38 | Facility | None | $1,737.80 | $4,365.16 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $1,445.44 Typical High $1,659.59 | Professional | None | $851.14 | $1,445.44 | $1,659.59 |
BCBS Idaho Setting Facility Modifier None Typical Low $5,495.41 Median $9,120.11 Typical High $26,915.35 | Facility | None | $5,495.41 | $9,120.11 | $26,915.35 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,288.25 Median $1,479.11 Typical High $1,584.89 | Professional | None | $1,288.25 | $1,479.11 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $5,623.41 Median $6,309.57 Typical High $8,511.38 | Facility | None | $5,623.41 | $6,309.57 | $8,511.38 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,202.26 Typical High $1,412.54 | Professional | None | $1,047.13 | $1,202.26 | $1,412.54 |
Moda Health Setting Facility Modifier None Typical Low $977.24 Median $1,737.80 Typical High $8,511.38 | Facility | None | $977.24 | $1,737.80 | $8,511.38 |
Moda Health Setting Professional Modifier None Typical Low $977.24 Median $1,445.44 Typical High $1,698.24 | Professional | None | $977.24 | $1,445.44 | $1,698.24 |
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 $1,148.15 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,148.15 | $1,412.54 | $1,412.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $2,511.89 | Professional | None | $1,412.54 | $1,412.54 | $2,511.89 |
Regence BlueShield Setting Facility Modifier None Typical Low $17,378.01 Median $24,547.09 Typical High $33,884.42 | Facility | None | $17,378.01 | $24,547.09 | $33,884.42 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,584.89 | Professional | None | $1,288.25 | $1,288.25 | $1,584.89 |
Select Health Setting Facility Modifier None Typical Low $676.08 Median $691.83 Typical High $11,748.98 | Facility | None | $676.08 | $691.83 | $11,748.98 |
Select Health Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $1,047.13 | Professional | None | $676.08 | $676.08 | $1,047.13 |
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 $891.25 Median $1,288.25 Typical High $1,819.70 | Professional | None | $891.25 | $1,288.25 | $1,819.70 |
13 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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $724.44 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $676.08 | $1,023.29 | $1,023.29 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,348.96 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,148.15 | $1,348.96 | $1,445.44 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $151.36 Typical High $158.49 | Professional | 55 · Aftercare only | $128.82 | $151.36 | $158.49 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $794.33 Median $954.99 Typical High $1,000.00 | Professional | 62 · Two surgeons | $794.33 | $954.99 | $1,000.00 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,548.82 Median $1,819.70 Typical High $1,905.46 | Professional | 63 · Small infant | $1,548.82 | $1,819.70 | $1,905.46 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,047.13 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $891.25 | $1,047.13 | $1,122.02 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $239.88 Typical High $257.04 | Professional | 80 · Assistant surgeon | $204.17 | $239.88 | $257.04 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $204.17 Median $239.88 Typical High $257.04 | Professional | 81 · Minimal assistant surgeon | $204.17 | $239.88 | $257.04 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $204.17 Median $239.88 Typical High $257.04 | Professional | 82 · Assistant surgeon, no resident | $204.17 | $239.88 | $257.04 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $204.17 Typical High $218.78 | Professional | AS · PA/NP assist | $173.78 | $204.17 | $218.78 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $724.44 | $1,096.48 | $1,096.48 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $676.08 | $1,023.29 | $1,023.29 |
Where Idaho sits
The same service costs 6.1 times more in Colorado 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
CO $15,685MT $2,577
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.