How much rates vary
Facilitymedian $1,479 · 10th to 90th $550 to $7,079Professionalmedian $3,090 · 10th to 90th $1,950 to $5,012
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 $1,778.28 Median $5,011.87 Typical High $5,011.87 | Professional | None | $1,778.28 | $5,011.87 | $5,011.87 |
BCBS Idaho Setting Facility Modifier None Typical Low $6,309.57 Median $6,760.83 Typical High $8,128.31 | Facility | None | $6,309.57 | $6,760.83 | $8,128.31 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,884.03 Median $3,388.44 Typical High $3,548.13 | Professional | None | $2,884.03 | $3,388.44 | $3,548.13 |
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 $2,089.30 Median $2,511.89 Typical High $2,884.03 | Professional | None | $2,089.30 | $2,511.89 | $2,884.03 |
Moda Health Setting Facility Modifier None Typical Low $1,445.44 Median $5,011.87 Typical High $7,244.36 | Facility | None | $1,445.44 | $5,011.87 | $7,244.36 |
Moda Health Setting Professional Modifier None Typical Low $2,398.83 Median $3,311.31 Typical High $5,011.87 | Professional | None | $2,398.83 | $3,311.31 | $5,011.87 |
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 $2,511.89 Median $3,090.30 Typical High $3,090.30 | Facility | None | $2,511.89 | $3,090.30 | $3,090.30 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,388.44 | Professional | None | $3,090.30 | $3,090.30 | $3,388.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,951.21 Median $3,548.13 Typical High $3,548.13 | Professional | None | $2,951.21 | $3,548.13 | $3,548.13 |
Select Health Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,584.89 | Facility | None | $1,479.11 | $1,479.11 | $1,584.89 |
Select Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $3,235.94 | Professional | None | $1,479.11 | $1,479.11 | $3,235.94 |
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 $1,862.09 Median $2,454.71 Typical High $3,801.89 | Professional | None | $1,862.09 | $2,454.71 | $3,801.89 |
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 $1,000.00 Median $2,511.89 Typical High $2,511.89 | Professional | 52 · Reduced service | $1,000.00 | $2,511.89 | $2,511.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $1,023.29 Typical High $1,023.29 | Professional | 53 · Discontinued | $398.11 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $3,801.89 Typical High $3,801.89 | Professional | 54 · Surgery only | $1,513.56 | $3,801.89 | $3,801.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $758.58 Typical High $758.58 | Professional | 55 · Aftercare only | $302.00 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $501.19 Typical High $501.19 | Professional | 56 · Pre-op care only | $199.53 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $3,548.13 Typical High $3,548.13 | Professional | 78 · Unplanned return to OR | $1,412.54 | $3,548.13 | $3,548.13 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,570.40 Median $2,951.21 Typical High $3,162.28 | Professional | 54 · Surgery only | $2,570.40 | $2,951.21 | $3,162.28 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $331.13 Typical High $346.74 | Professional | 55 · Aftercare only | $288.40 | $331.13 | $346.74 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,778.28 Median $2,041.74 Typical High $2,187.76 | Professional | 62 · Two surgeons | $1,778.28 | $2,041.74 | $2,187.76 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $3,467.37 Median $3,981.07 Typical High $4,168.69 | Professional | 63 · Small infant | $3,467.37 | $3,981.07 | $4,168.69 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,995.26 Median $2,290.87 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $1,995.26 | $2,290.87 | $2,454.71 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $457.09 Median $524.81 Typical High $549.54 | Professional | 80 · Assistant surgeon | $457.09 | $524.81 | $549.54 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $457.09 Median $524.81 Typical High $549.54 | Professional | 81 · Minimal assistant surgeon | $457.09 | $524.81 | $549.54 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $457.09 Median $524.81 Typical High $549.54 | Professional | 82 · Assistant surgeon, no resident | $457.09 | $524.81 | $549.54 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $389.05 Median $446.68 Typical High $467.74 | Professional | AS · PA/NP assist | $389.05 | $446.68 | $467.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,202.26 Median $2,511.89 Typical High $2,511.89 | Professional | 52 · Reduced service | $1,202.26 | $2,511.89 | $2,511.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $1,023.29 Typical High $1,023.29 | Professional | 53 · Discontinued | $478.63 | $1,023.29 | $1,023.29 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $3,801.89 Typical High $3,801.89 | Professional | 54 · Surgery only | $1,778.28 | $3,801.89 | $3,801.89 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $758.58 Typical High $758.58 | Professional | 55 · Aftercare only | $354.81 | $758.58 | $758.58 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $501.19 Typical High $501.19 | Professional | 56 · Pre-op care only | $239.88 | $501.19 | $501.19 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $3,548.13 Typical High $3,548.13 | Professional | 78 · Unplanned return to OR | $1,659.59 | $3,548.13 | $3,548.13 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Professional | 22 · Increased work | $3,715.35 | $3,715.35 | $3,715.35 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | 54 · Surgery only | $2,344.23 | $2,344.23 | $2,344.23 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | 56 · Pre-op care only | $338.84 | $338.84 | $338.84 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | 62 · Two surgeons | $2,089.30 | $2,089.30 | $2,089.30 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Professional | 63 · Small infant | $3,715.35 | $3,715.35 | $3,715.35 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $2,511.89 | $2,511.89 | $2,511.89 |
Where Idaho sits
The same service costs 7.6 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 $18,140MD $2,382
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.