How much rates vary
Facilitymedian $2,630 · 10th to 90th $1,175 to $5,495Professionalmedian $2,455 · 10th to 90th $1,445 to $3,981
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 $4,365.16 Median $4,466.84 Typical High $8,511.38 | Facility | None | $4,365.16 | $4,466.84 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $3,981.07 Typical High $3,981.07 | Professional | None | $1,318.26 | $3,981.07 | $3,981.07 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,548.13 Median $3,801.89 Typical High $4,897.79 | Facility | None | $3,548.13 | $3,801.89 | $4,897.79 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,238.72 Median $2,630.27 Typical High $2,754.23 | Professional | None | $2,238.72 | $2,630.27 | $2,754.23 |
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 $1,659.59 Median $1,949.84 Typical High $2,290.87 | Professional | None | $1,659.59 | $1,949.84 | $2,290.87 |
Moda Health Setting Facility Modifier None Typical Low $1,445.44 Median $3,981.07 Typical High $5,754.40 | Facility | None | $1,445.44 | $3,981.07 | $5,754.40 |
Moda Health Setting Professional Modifier None Typical Low $1,380.38 Median $2,630.27 Typical High $3,981.07 | Professional | None | $1,380.38 | $2,630.27 | $3,981.07 |
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 $1,995.26 Median $2,454.71 Typical High $2,454.71 | Facility | None | $1,995.26 | $2,454.71 | $2,454.71 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,630.27 | Professional | None | $2,454.71 | $2,454.71 | $2,630.27 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,344.23 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,344.23 | $2,754.23 | $2,754.23 |
Select Health Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,258.93 | Facility | None | $1,174.90 | $1,174.90 | $1,258.93 |
Select Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $2,570.40 | Professional | None | $1,174.90 | $1,174.90 | $2,570.40 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $3,388.44 | Facility | None | $1,698.24 | $2,238.72 | $3,388.44 |
United Setting Professional Modifier None Typical Low $1,513.56 Median $1,949.84 Typical High $2,951.21 | Professional | None | $1,513.56 | $1,949.84 | $2,951.21 |
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 $776.25 Median $1,995.26 Typical High $1,995.26 | Professional | 52 · Reduced service | $776.25 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $794.33 Typical High $794.33 | Professional | 53 · Discontinued | $316.23 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $3,019.95 Typical High $3,019.95 | Professional | 54 · Surgery only | $1,174.90 | $3,019.95 | $3,019.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $602.56 Typical High $602.56 | Professional | 55 · Aftercare only | $234.42 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $398.11 Typical High $398.11 | Professional | 56 · Pre-op care only | $154.88 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $2,818.38 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $1,096.48 | $2,818.38 | $2,818.38 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,344.23 Typical High $2,454.71 | Professional | 54 · Surgery only | $2,041.74 | $2,344.23 | $2,454.71 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $257.04 Typical High $275.42 | Professional | 55 · Aftercare only | $223.87 | $257.04 | $275.42 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,412.54 Median $1,621.81 Typical High $1,698.24 | Professional | 62 · Two surgeons | $1,412.54 | $1,621.81 | $1,698.24 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,691.53 Median $3,090.30 Typical High $3,311.31 | Professional | 63 · Small infant | $2,691.53 | $3,090.30 | $3,311.31 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,819.70 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,819.70 | $1,905.46 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $363.08 Median $416.87 Typical High $436.52 | Professional | 80 · Assistant surgeon | $363.08 | $416.87 | $436.52 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $363.08 Median $416.87 Typical High $436.52 | Professional | 81 · Minimal assistant surgeon | $363.08 | $416.87 | $436.52 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $363.08 Median $416.87 Typical High $436.52 | Professional | 82 · Assistant surgeon, no resident | $363.08 | $416.87 | $436.52 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $309.03 Median $354.81 Typical High $371.54 | Professional | AS · PA/NP assist | $309.03 | $354.81 | $371.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $933.25 Median $1,995.26 Typical High $1,995.26 | Professional | 52 · Reduced service | $933.25 | $1,995.26 | $1,995.26 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $794.33 Typical High $794.33 | Professional | 53 · Discontinued | $371.54 | $794.33 | $794.33 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $3,019.95 Typical High $3,019.95 | Professional | 54 · Surgery only | $1,412.54 | $3,019.95 | $3,019.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $602.56 Typical High $602.56 | Professional | 55 · Aftercare only | $281.84 | $602.56 | $602.56 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $398.11 Typical High $398.11 | Professional | 56 · Pre-op care only | $186.21 | $398.11 | $398.11 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $2,818.38 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $1,148.15 | $2,818.38 | $2,818.38 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Professional | 22 · Increased work | $2,884.03 | $2,884.03 | $2,884.03 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,862.09 | $1,862.09 | $1,862.09 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $263.03 | $263.03 | $263.03 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | 62 · Two surgeons | $1,659.59 | $1,659.59 | $1,659.59 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Professional | 63 · Small infant | $2,884.03 | $2,884.03 | $2,884.03 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,995.26 | $1,995.26 | $1,995.26 |
Where Idaho sits
The same service costs 8.5 times more in Maine than in Delaware. 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 $28,081DE $3,299
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.