How much rates vary
Facilitymedian $263 · 10th to 90th $89 to $977Professionalmedian $126 · 10th to 90th $74 to $224
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 $138.04 Median $234.42 Typical High $4,466.84 | Facility | None | $138.04 | $234.42 | $4,466.84 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $125.89 Typical High $223.87 | Professional | None | $63.10 | $125.89 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $95.50 Typical High $165.96 | Professional | 54 · Surgery only | $47.86 | $95.50 | $165.96 |
BCBS Idaho Setting Facility Modifier None Typical Low $181.97 Median $380.19 Typical High $1,096.48 | Facility | None | $181.97 | $380.19 | $1,096.48 |
BCBS Idaho Setting Professional Modifier None Typical Low $83.18 Median $144.54 Typical High $204.17 | Professional | None | $83.18 | $144.54 | $204.17 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $89.13 Typical High $190.55 | Professional | 54 · Surgery only | $72.44 | $89.13 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $97.72 Typical High $144.54 | Professional | None | $74.13 | $97.72 | $144.54 |
Moda Health Setting Facility Modifier None Typical Low $120.23 Median $263.03 Typical High $1,412.54 | Facility | None | $120.23 | $263.03 | $1,412.54 |
Moda Health Setting Professional Modifier None Typical Low $72.44 Median $125.89 Typical High $223.87 | Professional | None | $72.44 | $125.89 | $223.87 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $95.50 Typical High $165.96 | Professional | 54 · Surgery only | $47.86 | $95.50 | $165.96 |
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 $87.10 Median $87.10 Typical High $186.21 | Facility | None | $87.10 | $87.10 | $186.21 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $87.10 Median $125.89 Typical High $234.42 | Professional | None | $87.10 | $125.89 | $234.42 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $89.13 Typical High $158.49 | Professional | 54 · Surgery only | $89.13 | $89.13 | $158.49 |
Regence BlueShield Setting Professional Modifier None Typical Low $100.00 Median $125.89 Typical High $218.78 | Professional | None | $100.00 | $125.89 | $218.78 |
Select Health Setting Facility Modifier None Typical Low $89.13 Median $91.20 Typical High $436.52 | Facility | None | $89.13 | $91.20 | $436.52 |
Select Health Setting Professional Modifier None Typical Low $51.29 Median $89.13 Typical High $114.82 | Professional | None | $51.29 | $89.13 | $114.82 |
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 $56.23 Median $95.50 Typical High $169.82 | Professional | None | $56.23 | $95.50 | $169.82 |
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 |
|---|---|---|---|---|---|
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $269.15 Median $575.44 Typical High $1,659.59 | Facility | 50 · Both sides | $269.15 | $575.44 | $1,659.59 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $120.23 Median $144.54 Typical High $309.03 | Professional | 50 · Both sides | $120.23 | $144.54 | $309.03 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $17.38 Typical High $20.42 | Professional | 55 · Aftercare only | $8.13 | $17.38 | $20.42 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $100.00 Median $173.78 Typical High $239.88 | Professional | 63 · Small infant | $100.00 | $173.78 | $239.88 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $56.23 Median $114.82 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $56.23 | $114.82 | $144.54 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $12.88 Median $22.91 Typical High $32.36 | Professional | 80 · Assistant surgeon | $12.88 | $22.91 | $32.36 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $12.88 Median $15.85 Typical High $33.88 | Professional | 81 · Minimal assistant surgeon | $12.88 | $15.85 | $33.88 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $12.88 Median $20.42 Typical High $32.36 | Professional | 82 · Assistant surgeon, no resident | $12.88 | $20.42 | $32.36 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $10.96 Median $13.18 Typical High $28.84 | Professional | AS · PA/NP assist | $10.96 | $13.18 | $28.84 |
Moda Health Setting Professional Modifier 50 · Both sides Typical Low $70.79 Median $114.82 Typical High $489.78 | Professional | 50 · Both sides | $70.79 | $114.82 | $489.78 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $190.55 Median $190.55 Typical High $338.84 | Professional | 50 · Both sides | $190.55 | $190.55 | $338.84 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $22.39 | Professional | 56 · Pre-op care only | $12.59 | $12.59 | $22.39 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $95.50 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $95.50 | $95.50 | $169.82 |
Where Idaho sits
The same service costs 15.3 times more in Hawaii 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
HI $2,931MT $192
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.