How much rates vary
Facilitymedian $525 · 10th to 90th $229 to $2,089Professionalmedian $204 · 10th to 90th $112 to $550
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 $97.72 Median $213.80 Typical High $562.34 | Professional | None | $97.72 | $213.80 | $562.34 |
BCBS Idaho Setting Facility Modifier None Typical Low $524.81 Median $1,096.48 Typical High $2,089.30 | Facility | None | $524.81 | $1,096.48 | $2,089.30 |
BCBS Idaho Setting Professional Modifier None Typical Low $138.04 Median $363.08 Typical High $512.86 | Professional | None | $138.04 | $363.08 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $478.63 Typical High $645.65 | Facility | None | $426.58 | $478.63 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $190.55 Typical High $346.74 | Professional | None | $112.20 | $190.55 | $346.74 |
Moda Health Setting Facility Modifier None Typical Low $97.72 Median $302.00 Typical High $5,495.41 | Facility | None | $97.72 | $302.00 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $120.23 Median $239.88 Typical High $562.34 | Professional | None | $120.23 | $239.88 | $562.34 |
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 $144.54 Median $144.54 Typical High $467.74 | Facility | None | $144.54 | $144.54 | $467.74 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $144.54 Median $204.17 Typical High $588.84 | Professional | None | $144.54 | $204.17 | $588.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,230.27 Median $1,778.28 Typical High $2,238.72 | Facility | None | $1,230.27 | $1,778.28 | $2,238.72 |
Regence BlueShield Setting Professional Modifier None Typical Low $162.18 Median $302.00 Typical High $549.54 | Professional | None | $162.18 | $302.00 | $549.54 |
Select Health Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $2,089.30 | Facility | None | $223.87 | $223.87 | $2,089.30 |
Select Health Setting Professional Modifier None Typical Low $83.18 Median $223.87 Typical High $436.52 | Professional | None | $83.18 | $223.87 | $436.52 |
United Setting Facility Modifier None Typical Low $363.08 Median $501.19 Typical High $724.44 | Facility | None | $363.08 | $501.19 | $724.44 |
United Setting Professional Modifier None Typical Low $87.10 Median $181.97 Typical High $380.19 | Professional | None | $87.10 | $181.97 | $380.19 |
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 Facility Modifier 50 · Both sides Typical Low $776.25 Median $1,230.27 Typical High $3,162.28 | Facility | 50 · Both sides | $776.25 | $1,230.27 | $3,162.28 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $199.53 Median $234.42 Typical High $758.58 | Professional | 50 · Both sides | $199.53 | $234.42 | $758.58 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $144.54 Typical High $457.09 | Professional | 54 · Surgery only | $120.23 | $144.54 | $457.09 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $36.31 Typical High $51.29 | Professional | 55 · Aftercare only | $13.18 | $36.31 | $51.29 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $158.49 Median $194.98 Typical High $602.56 | Professional | 63 · Small infant | $158.49 | $194.98 | $602.56 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $302.00 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $107.15 | $302.00 | $354.81 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $309.03 Median $309.03 Typical High $851.14 | Professional | 50 · Both sides | $309.03 | $309.03 | $851.14 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $144.54 Typical High $398.11 | Professional | 54 · Surgery only | $144.54 | $144.54 | $398.11 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $56.23 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $56.23 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $154.88 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $154.88 | $154.88 | $426.58 |
Where Idaho sits
The same service costs 6.8 times more in New York than in North Dakota. 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 $2,910ND $428
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.