How much rates vary
Facilitymedian $676 · 10th to 90th $331 to $1,514Professionalmedian $417 · 10th to 90th $288 to $490
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 $4,466.84 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $457.09 Typical High $457.09 | Professional | None | $257.04 | $457.09 | $457.09 |
BCBS Idaho Setting Facility Modifier None Typical Low $954.99 Median $1,023.29 Typical High $1,230.27 | Facility | None | $954.99 | $1,023.29 | $1,230.27 |
BCBS Idaho Setting Professional Modifier None Typical Low $407.38 Median $426.58 Typical High $501.19 | Professional | None | $407.38 | $426.58 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $1,380.38 Typical High $12,589.25 | Facility | None | $151.36 | $1,380.38 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $389.05 Typical High $446.68 | Professional | None | $331.13 | $389.05 | $446.68 |
Moda Health Setting Facility Modifier None Typical Low $213.80 Median $457.09 Typical High $4,466.84 | Facility | None | $213.80 | $457.09 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $331.13 Median $457.09 Typical High $489.78 | Professional | None | $331.13 | $457.09 | $489.78 |
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 $371.54 Median $416.87 Typical High $416.87 | Facility | None | $371.54 | $416.87 | $416.87 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $489.78 | Professional | None | $416.87 | $416.87 | $489.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $489.78 | Professional | None | $407.38 | $407.38 | $489.78 |
Select Health Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $234.42 | Facility | None | $213.80 | $213.80 | $234.42 |
Select Health Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $331.13 | Professional | None | $213.80 | $213.80 | $331.13 |
United Setting Facility Modifier None Typical Low $436.52 Median $676.08 Typical High $870.96 | Facility | None | $436.52 | $676.08 | $870.96 |
United Setting Professional Modifier None Typical Low $263.03 Median $380.19 Typical High $575.44 | Professional | None | $263.03 | $380.19 | $575.44 |
19 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 52 · Reduced service Typical Low $141.25 Median $229.09 Typical High $229.09 | Professional | 52 · Reduced service | $141.25 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $91.20 Typical High $91.20 | Professional | 53 · Discontinued | $56.23 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $338.84 Typical High $338.84 | Professional | 54 · Surgery only | $213.80 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $42.66 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $45.71 Typical High $45.71 | Professional | 56 · Pre-op care only | $28.18 | $45.71 | $45.71 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $436.52 Typical High $457.09 | Professional | 54 · Surgery only | $363.08 | $436.52 | $457.09 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $47.86 Typical High $50.12 | Professional | 55 · Aftercare only | $40.74 | $47.86 | $50.12 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $251.19 Median $302.00 Typical High $316.23 | Professional | 62 · Two surgeons | $251.19 | $302.00 | $316.23 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $489.78 Median $575.44 Typical High $602.56 | Professional | 63 · Small infant | $489.78 | $575.44 | $602.56 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $338.84 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $281.84 | $338.84 | $354.81 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $64.57 Median $77.62 Typical High $81.28 | Professional | 80 · Assistant surgeon | $64.57 | $77.62 | $81.28 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $64.57 Median $77.62 Typical High $81.28 | Professional | 81 · Minimal assistant surgeon | $64.57 | $77.62 | $81.28 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $64.57 Median $77.62 Typical High $81.28 | Professional | 82 · Assistant surgeon, no resident | $64.57 | $77.62 | $81.28 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $54.95 Median $66.07 Typical High $69.18 | Professional | AS · PA/NP assist | $54.95 | $66.07 | $69.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $165.96 Median $229.09 Typical High $229.09 | Professional | 52 · Reduced service | $165.96 | $229.09 | $229.09 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $91.20 Typical High $91.20 | Professional | 53 · Discontinued | $66.07 | $91.20 | $91.20 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $338.84 Typical High $338.84 | Professional | 54 · Surgery only | $251.19 | $338.84 | $338.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $50.12 | $69.18 | $69.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $45.71 Typical High $45.71 | Professional | 56 · Pre-op care only | $33.11 | $45.71 | $45.71 |
Where Idaho sits
The same service costs 32.0 times more in Maine 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
ME $26,674MT $834
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.