How much rates vary
Facilitymedian $1,318 · 10th to 90th $550 to $6,166Professionalmedian $2,754 · 10th to 90th $1,738 to $4,467
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 $4,466.84 Typical High $4,466.84 | Professional | None | $1,778.28 | $4,466.84 | $4,466.84 |
BCBS Idaho Setting Facility Modifier None Typical Low $5,495.41 Median $5,888.44 Typical High $7,244.36 | Facility | None | $5,495.41 | $5,888.44 | $7,244.36 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,511.89 Median $2,951.21 Typical High $3,090.30 | Professional | None | $2,511.89 | $2,951.21 | $3,090.30 |
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 $1,862.09 Median $2,187.76 Typical High $2,570.40 | Professional | None | $1,862.09 | $2,187.76 | $2,570.40 |
Moda Health Setting Facility Modifier None Typical Low $1,318.26 Median $4,466.84 Typical High $6,456.54 | Facility | None | $1,318.26 | $4,466.84 | $6,456.54 |
Moda Health Setting Professional Modifier None Typical Low $2,089.30 Median $2,951.21 Typical High $4,466.84 | Professional | None | $2,089.30 | $2,951.21 | $4,466.84 |
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 $2,238.72 Median $2,754.23 Typical High $2,754.23 | Facility | None | $2,238.72 | $2,754.23 | $2,754.23 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,951.21 | Professional | None | $2,754.23 | $2,754.23 | $2,951.21 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,630.27 Median $3,090.30 Typical High $3,090.30 | Professional | None | $2,630.27 | $3,090.30 | $3,090.30 |
Select Health Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,412.54 | Facility | None | $1,318.26 | $1,318.26 | $1,412.54 |
Select Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $2,884.03 | Professional | None | $1,318.26 | $1,318.26 | $2,884.03 |
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 $1,659.59 Median $2,187.76 Typical High $3,311.31 | Professional | None | $1,659.59 | $2,187.76 | $3,311.31 |
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 $870.96 Median $2,238.72 Typical High $2,238.72 | Professional | 52 · Reduced service | $870.96 | $2,238.72 | $2,238.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $891.25 Typical High $891.25 | Professional | 53 · Discontinued | $354.81 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $3,388.44 Typical High $3,388.44 | Professional | 54 · Surgery only | $1,318.26 | $3,388.44 | $3,388.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $676.08 Typical High $676.08 | Professional | 55 · Aftercare only | $263.03 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $446.68 Typical High $446.68 | Professional | 56 · Pre-op care only | $177.83 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $3,162.28 Typical High $3,162.28 | Professional | 78 · Unplanned return to OR | $1,230.27 | $3,162.28 | $3,162.28 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,290.87 Median $2,630.27 Typical High $2,754.23 | Professional | 54 · Surgery only | $2,290.87 | $2,630.27 | $2,754.23 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $288.40 Typical High $309.03 | Professional | 55 · Aftercare only | $251.19 | $288.40 | $309.03 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,584.89 Median $1,819.70 Typical High $1,905.46 | Professional | 62 · Two surgeons | $1,584.89 | $1,819.70 | $1,905.46 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $3,019.95 Median $3,467.37 Typical High $3,715.35 | Professional | 63 · Small infant | $3,019.95 | $3,467.37 | $3,715.35 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $2,041.74 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,778.28 | $2,041.74 | $2,137.96 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $407.38 Median $467.74 Typical High $489.78 | Professional | 80 · Assistant surgeon | $407.38 | $467.74 | $489.78 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $407.38 Median $467.74 Typical High $489.78 | Professional | 81 · Minimal assistant surgeon | $407.38 | $467.74 | $489.78 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $407.38 Median $467.74 Typical High $489.78 | Professional | 82 · Assistant surgeon, no resident | $407.38 | $467.74 | $489.78 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $346.74 Median $398.11 Typical High $416.87 | Professional | AS · PA/NP assist | $346.74 | $398.11 | $416.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,047.13 Median $2,238.72 Typical High $2,238.72 | Professional | 52 · Reduced service | $1,047.13 | $2,238.72 | $2,238.72 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $891.25 Typical High $891.25 | Professional | 53 · Discontinued | $426.58 | $891.25 | $891.25 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $3,388.44 Typical High $3,388.44 | Professional | 54 · Surgery only | $1,584.89 | $3,388.44 | $3,388.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $676.08 Typical High $676.08 | Professional | 55 · Aftercare only | $316.23 | $676.08 | $676.08 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $446.68 Typical High $446.68 | Professional | 56 · Pre-op care only | $208.93 | $446.68 | $446.68 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $3,162.28 Typical High $3,162.28 | Professional | 78 · Unplanned return to OR | $1,479.11 | $3,162.28 | $3,162.28 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Professional | 22 · Increased work | $3,235.94 | $3,235.94 | $3,235.94 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | 54 · Surgery only | $2,089.30 | $2,089.30 | $2,089.30 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $295.12 | $295.12 | $295.12 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | 62 · Two surgeons | $1,862.09 | $1,862.09 | $1,862.09 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Professional | 63 · Small infant | $3,235.94 | $3,235.94 | $3,235.94 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $2,238.72 | $2,238.72 | $2,238.72 |
Where Idaho sits
The same service costs 8.2 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 $17,891MD $2,184
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.