How much rates vary
Facilitymedian $1,096 · 10th to 90th $550 to $5,012Professionalmedian $2,291 · 10th to 90th $1,413 to $3,631
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 $1,318.26 Median $3,630.78 Typical High $3,630.78 | Professional | None | $1,318.26 | $3,630.78 | $3,630.78 |
BCBS Setting Facility Modifier None Typical Low $3,090.30 Median $4,677.35 Typical High $5,623.41 | Facility | None | $3,090.30 | $4,677.35 | $5,623.41 |
BCBS Setting Professional Modifier None Typical Low $2,089.30 Median $2,454.71 Typical High $2,570.40 | Professional | None | $2,089.30 | $2,454.71 | $2,570.40 |
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 $1,479.11 Median $1,819.70 Typical High $2,089.30 | Professional | None | $1,479.11 | $1,819.70 | $2,089.30 |
Moda Health Setting Facility Modifier None Typical Low $1,096.48 Median $3,630.78 Typical High $5,248.07 | Facility | None | $1,096.48 | $3,630.78 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $1,737.80 Median $2,398.83 Typical High $3,630.78 | Professional | None | $1,737.80 | $2,398.83 | $3,630.78 |
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 $1,862.09 Median $2,290.87 Typical High $2,290.87 | Facility | None | $1,862.09 | $2,290.87 | $2,290.87 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,398.83 | Professional | None | $2,290.87 | $2,290.87 | $2,398.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,137.96 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,137.96 | $2,570.40 | $2,570.40 |
Select Health Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,174.90 | Facility | None | $1,096.48 | $1,096.48 | $1,174.90 |
Select Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $2,344.23 | Professional | None | $1,096.48 | $1,096.48 | $2,344.23 |
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 $1,288.25 Median $1,698.24 Typical High $2,570.40 | Professional | None | $1,288.25 | $1,698.24 | $2,570.40 |
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 $707.95 Median $1,819.70 Typical High $1,819.70 | Professional | 52 · Reduced service | $707.95 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $724.44 Typical High $724.44 | Professional | 53 · Discontinued | $281.84 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $2,754.23 Typical High $2,754.23 | Professional | 54 · Surgery only | $1,047.13 | $2,754.23 | $2,754.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $549.54 Typical High $549.54 | Professional | 55 · Aftercare only | $208.93 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $363.08 Typical High $363.08 | Professional | 56 · Pre-op care only | $141.25 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $2,570.40 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $977.24 | $2,570.40 | $2,570.40 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $2,187.76 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,905.46 | $2,187.76 | $2,290.87 |
BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $239.88 Typical High $257.04 | Professional | 55 · Aftercare only | $208.93 | $239.88 | $257.04 |
BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,318.26 Median $1,513.56 Typical High $1,584.89 | Professional | 62 · Two surgeons | $1,318.26 | $1,513.56 | $1,584.89 |
BCBS Setting Professional Modifier 63 · Small infant Typical Low $2,511.89 Median $2,884.03 Typical High $3,090.30 | Professional | 63 · Small infant | $2,511.89 | $2,884.03 | $3,090.30 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,698.24 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,698.24 | $1,778.28 |
BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $338.84 Median $389.05 Typical High $407.38 | Professional | 80 · Assistant surgeon | $338.84 | $389.05 | $407.38 |
BCBS Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $338.84 Median $389.05 Typical High $407.38 | Professional | 81 · Minimal assistant surgeon | $338.84 | $389.05 | $407.38 |
BCBS Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $338.84 Median $389.05 Typical High $407.38 | Professional | 82 · Assistant surgeon, no resident | $338.84 | $389.05 | $407.38 |
BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $288.40 Median $331.13 Typical High $346.74 | Professional | AS · PA/NP assist | $288.40 | $331.13 | $346.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $870.96 Median $1,819.70 Typical High $1,819.70 | Professional | 52 · Reduced service | $870.96 | $1,819.70 | $1,819.70 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $724.44 Typical High $724.44 | Professional | 53 · Discontinued | $346.74 | $724.44 | $724.44 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $2,754.23 Typical High $2,754.23 | Professional | 54 · Surgery only | $1,288.25 | $2,754.23 | $2,754.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $549.54 Typical High $549.54 | Professional | 55 · Aftercare only | $257.04 | $549.54 | $549.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $363.08 Typical High $363.08 | Professional | 56 · Pre-op care only | $173.78 | $363.08 | $363.08 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $2,570.40 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $1,202.26 | $2,570.40 | $2,570.40 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | 22 · Increased work | $2,630.27 | $2,630.27 | $2,630.27 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,698.24 | $1,698.24 | $1,698.24 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | 56 · Pre-op care only | $239.88 | $239.88 | $239.88 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | 62 · Two surgeons | $1,513.56 | $1,513.56 | $1,513.56 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | 63 · Small infant | $2,630.27 | $2,630.27 | $2,630.27 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,819.70 | $1,819.70 | $1,819.70 |
Where Idaho sits
The same service costs 8.1 times more in Maine than in Texas. 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 $13,962TX $1,718
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.