How much rates vary
Facilitymedian $851 · 10th to 90th $550 to $3,548Professionalmedian $1,413 · 10th to 90th $871 to $2,239
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 $851.14 Median $2,238.72 Typical High $2,238.72 | Professional | None | $851.14 | $2,238.72 | $2,238.72 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,754.23 Median $2,951.21 Typical High $3,548.13 | Facility | None | $2,754.23 | $2,951.21 | $3,548.13 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,288.25 Median $1,479.11 Typical High $1,584.89 | Professional | None | $1,288.25 | $1,479.11 | $1,584.89 |
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 $933.25 Median $1,122.02 Typical High $1,288.25 | Professional | None | $933.25 | $1,122.02 | $1,288.25 |
Moda Health Setting Facility Modifier None Typical Low $660.69 Median $2,238.72 Typical High $5,495.41 | Facility | None | $660.69 | $2,238.72 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,479.11 Typical High $2,238.72 | Professional | None | $1,071.52 | $1,479.11 | $2,238.72 |
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 $1,148.15 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,148.15 | $1,412.54 | $1,412.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,479.11 | Professional | None | $1,412.54 | $1,412.54 | $1,479.11 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,348.96 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,348.96 | $1,584.89 | $1,584.89 |
Select Health Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $724.44 | Facility | None | $660.69 | $660.69 | $724.44 |
Select Health Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,445.44 | Professional | None | $660.69 | $660.69 | $1,445.44 |
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 $812.83 Median $1,071.52 Typical High $1,659.59 | Professional | None | $812.83 | $1,071.52 | $1,659.59 |
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 $436.52 Median $1,122.02 Typical High $1,122.02 | Professional | 52 · Reduced service | $436.52 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $446.68 Typical High $446.68 | Professional | 53 · Discontinued | $173.78 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $1,698.24 Typical High $1,698.24 | Professional | 54 · Surgery only | $660.69 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $338.84 Typical High $338.84 | Professional | 55 · Aftercare only | $131.83 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $223.87 Typical High $223.87 | Professional | 56 · Pre-op care only | $87.10 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $1,584.89 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $616.60 | $1,584.89 | $1,584.89 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,348.96 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,174.90 | $1,348.96 | $1,412.54 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $147.91 Typical High $158.49 | Professional | 55 · Aftercare only | $128.82 | $147.91 | $158.49 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $812.83 Median $933.25 Typical High $977.24 | Professional | 62 · Two surgeons | $812.83 | $933.25 | $977.24 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,548.82 Median $1,778.28 Typical High $1,905.46 | Professional | 63 · Small infant | $1,548.82 | $1,778.28 | $1,905.46 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,047.13 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $912.01 | $1,047.13 | $1,096.48 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $239.88 Typical High $251.19 | Professional | 80 · Assistant surgeon | $208.93 | $239.88 | $251.19 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $208.93 Median $239.88 Typical High $251.19 | Professional | 81 · Minimal assistant surgeon | $208.93 | $239.88 | $251.19 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $208.93 Median $239.88 Typical High $251.19 | Professional | 82 · Assistant surgeon, no resident | $208.93 | $239.88 | $251.19 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $204.17 Typical High $213.80 | Professional | AS · PA/NP assist | $177.83 | $204.17 | $213.80 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $537.03 Median $1,122.02 Typical High $1,122.02 | Professional | 52 · Reduced service | $537.03 | $1,122.02 | $1,122.02 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $446.68 Typical High $446.68 | Professional | 53 · Discontinued | $213.80 | $446.68 | $446.68 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $1,698.24 Typical High $1,698.24 | Professional | 54 · Surgery only | $794.33 | $1,698.24 | $1,698.24 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $338.84 Typical High $338.84 | Professional | 55 · Aftercare only | $158.49 | $338.84 | $338.84 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $223.87 Typical High $223.87 | Professional | 56 · Pre-op care only | $107.15 | $223.87 | $223.87 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $1,584.89 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $741.31 | $1,584.89 | $1,584.89 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | 22 · Increased work | $1,659.59 | $1,659.59 | $1,659.59 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $1,047.13 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $147.91 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | 62 · Two surgeons | $933.25 | $933.25 | $933.25 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | 63 · Small infant | $1,659.59 | $1,659.59 | $1,659.59 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $1,122.02 |
Where Idaho sits
The same service costs 6.1 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 $8,436MD $1,394
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.