How much rates vary
Facilitymedian $851 · 10th to 90th $550 to $3,802Professionalmedian $1,622 · 10th to 90th $977 to $2,512
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 $870.96 Median $2,511.89 Typical High $2,511.89 | Professional | None | $870.96 | $2,511.89 | $2,511.89 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,162.28 Median $3,388.44 Typical High $4,073.80 | Facility | None | $3,162.28 | $3,388.44 | $4,073.80 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,479.11 Median $1,698.24 Typical High $1,778.28 | Professional | None | $1,479.11 | $1,698.24 | $1,778.28 |
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 $1,047.13 Median $1,258.93 Typical High $1,445.44 | Professional | None | $1,047.13 | $1,258.93 | $1,445.44 |
Moda Health Setting Facility Modifier None Typical Low $758.58 Median $2,511.89 Typical High $5,495.41 | Facility | None | $758.58 | $2,511.89 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,659.59 Typical High $2,511.89 | Professional | None | $1,047.13 | $1,659.59 | $2,511.89 |
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 $1,288.25 Median $1,584.89 Typical High $1,584.89 | Facility | None | $1,288.25 | $1,584.89 | $1,584.89 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,698.24 | Professional | None | $1,584.89 | $1,584.89 | $1,698.24 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,513.56 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,513.56 | $1,778.28 | $1,778.28 |
Select Health Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $812.83 | Facility | None | $758.58 | $758.58 | $812.83 |
Select Health Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,659.59 | Professional | None | $758.58 | $758.58 | $1,659.59 |
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 $954.99 Median $1,230.27 Typical High $1,905.46 | Professional | None | $954.99 | $1,230.27 | $1,905.46 |
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 $501.19 Median $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $501.19 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $501.19 Typical High $501.19 | Professional | 53 · Discontinued | $199.53 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $758.58 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $380.19 Typical High $380.19 | Professional | 55 · Aftercare only | $151.36 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $251.19 Typical High $251.19 | Professional | 56 · Pre-op care only | $100.00 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $1,778.28 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $707.95 | $1,778.28 | $1,778.28 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,513.56 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,318.26 | $1,513.56 | $1,621.81 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $169.82 Typical High $177.83 | Professional | 55 · Aftercare only | $147.91 | $169.82 | $177.83 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $912.01 Median $1,071.52 Typical High $1,122.02 | Professional | 62 · Two surgeons | $912.01 | $1,071.52 | $1,122.02 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,778.28 Median $2,041.74 Typical High $2,137.96 | Professional | 63 · Small infant | $1,778.28 | $2,041.74 | $2,137.96 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,202.26 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,202.26 | $1,258.93 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $269.15 Typical High $288.40 | Professional | 80 · Assistant surgeon | $234.42 | $269.15 | $288.40 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $234.42 Median $269.15 Typical High $288.40 | Professional | 81 · Minimal assistant surgeon | $234.42 | $269.15 | $288.40 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $234.42 Median $269.15 Typical High $288.40 | Professional | 82 · Assistant surgeon, no resident | $234.42 | $269.15 | $288.40 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $229.09 Typical High $245.47 | Professional | AS · PA/NP assist | $199.53 | $229.09 | $245.47 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $602.56 Median $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $602.56 | $1,258.93 | $1,258.93 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $501.19 Typical High $501.19 | Professional | 53 · Discontinued | $239.88 | $501.19 | $501.19 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $891.25 | $1,905.46 | $1,905.46 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $380.19 Typical High $380.19 | Professional | 55 · Aftercare only | $181.97 | $380.19 | $380.19 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $251.19 Typical High $251.19 | Professional | 56 · Pre-op care only | $120.23 | $251.19 | $251.19 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $1,778.28 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $831.76 | $1,778.28 | $1,778.28 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | 22 · Increased work | $1,862.09 | $1,862.09 | $1,862.09 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $1,202.26 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $169.82 | $169.82 | $169.82 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | 62 · Two surgeons | $1,071.52 | $1,071.52 | $1,071.52 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | 63 · Small infant | $1,862.09 | $1,862.09 | $1,862.09 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,288.25 | $1,288.25 |
Where Idaho sits
The same service costs 11.4 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 $16,997MD $1,496
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.