How much rates vary
Facilitymedian $871 · 10th to 90th $550 to $4,467Professionalmedian $1,514 · 10th to 90th $955 to $2,512
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 $4,677.35 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,677.35 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $2,511.89 Typical High $2,511.89 | Professional | None | $851.14 | $2,511.89 | $2,511.89 |
BCBS Setting Facility Modifier None Typical Low $3,090.30 Median $3,311.31 Typical High $3,981.07 | Facility | None | $3,090.30 | $3,311.31 | $3,981.07 |
BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $1,621.81 Typical High $1,698.24 | Professional | None | $1,380.38 | $1,621.81 | $1,698.24 |
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 $1,023.29 Median $1,230.27 Typical High $1,412.54 | Professional | None | $1,023.29 | $1,230.27 | $1,412.54 |
Moda Health Setting Facility Modifier None Typical Low $724.44 Median $2,511.89 Typical High $4,677.35 | Facility | None | $724.44 | $2,511.89 | $4,677.35 |
Moda Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,621.81 Typical High $2,511.89 | Professional | None | $1,047.13 | $1,621.81 | $2,511.89 |
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 $1,230.27 Median $1,513.56 Typical High $1,513.56 | Facility | None | $1,230.27 | $1,513.56 | $1,513.56 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,659.59 | Professional | None | $1,513.56 | $1,513.56 | $1,659.59 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,445.44 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,445.44 | $1,698.24 | $1,698.24 |
Select Health Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $758.58 | Facility | None | $724.44 | $724.44 | $758.58 |
Select Health Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $1,584.89 | Professional | None | $724.44 | $724.44 | $1,584.89 |
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 $912.01 Median $1,202.26 Typical High $1,862.09 | Professional | None | $912.01 | $1,202.26 | $1,862.09 |
27 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 $489.78 Median $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $489.78 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $501.19 Typical High $501.19 | Professional | 53 · Discontinued | $194.98 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,862.09 Typical High $1,862.09 | Professional | 54 · Surgery only | $724.44 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $371.54 Typical High $371.54 | Professional | 55 · Aftercare only | $144.54 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $251.19 Typical High $251.19 | Professional | 56 · Pre-op care only | $97.72 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $1,737.80 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $676.08 | $1,737.80 | $1,737.80 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,445.44 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,258.93 | $1,445.44 | $1,513.56 |
BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $162.18 Typical High $169.82 | Professional | 55 · Aftercare only | $138.04 | $162.18 | $169.82 |
BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $870.96 Median $1,000.00 Typical High $1,047.13 | Professional | 62 · Two surgeons | $870.96 | $1,000.00 | $1,047.13 |
BCBS Setting Professional Modifier 63 · Small infant Typical Low $1,659.59 Median $1,905.46 Typical High $2,041.74 | Professional | 63 · Small infant | $1,659.59 | $1,905.46 | $2,041.74 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,122.02 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $977.24 | $1,122.02 | $1,174.90 |
BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $257.04 Typical High $269.15 | Professional | 80 · Assistant surgeon | $223.87 | $257.04 | $269.15 |
BCBS Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $223.87 Median $257.04 Typical High $269.15 | Professional | 81 · Minimal assistant surgeon | $223.87 | $257.04 | $269.15 |
BCBS Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $223.87 Median $257.04 Typical High $269.15 | Professional | 82 · Assistant surgeon, no resident | $223.87 | $257.04 | $269.15 |
BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $218.78 Typical High $229.09 | Professional | AS · PA/NP assist | $190.55 | $218.78 | $229.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $588.84 Median $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $588.84 | $1,258.93 | $1,258.93 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $501.19 Typical High $501.19 | Professional | 53 · Discontinued | $234.42 | $501.19 | $501.19 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,862.09 Typical High $1,862.09 | Professional | 54 · Surgery only | $870.96 | $1,862.09 | $1,862.09 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $371.54 Typical High $371.54 | Professional | 55 · Aftercare only | $173.78 | $371.54 | $371.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $251.19 Typical High $251.19 | Professional | 56 · Pre-op care only | $117.49 | $251.19 | $251.19 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,737.80 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $812.83 | $1,737.80 | $1,737.80 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | 22 · Increased work | $1,819.70 | $1,819.70 | $1,819.70 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $1,148.15 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $165.96 | $165.96 | $165.96 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | 62 · Two surgeons | $1,023.29 | $1,023.29 | $1,023.29 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | 63 · Small infant | $1,819.70 | $1,819.70 | $1,819.70 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,230.27 | $1,230.27 |
Where Idaho sits
The same service costs 11.8 times more in Maine than in Maryland. 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 $16,971MD $1,433
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.