How much rates vary
Facilitymedian $933 · 10th to 90th $550 to $4,467Professionalmedian $1,995 · 10th to 90th $1,230 to $3,162
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 $3,162.28 Typical High $3,162.28 | Professional | None | $1,318.26 | $3,162.28 | $3,162.28 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,981.07 Median $4,265.80 Typical High $5,128.61 | Facility | None | $3,981.07 | $4,265.80 | $5,128.61 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,819.70 Median $2,137.96 Typical High $2,238.72 | Professional | None | $1,819.70 | $2,137.96 | $2,238.72 |
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 $1,318.26 Median $1,548.82 Typical High $1,819.70 | Professional | None | $1,318.26 | $1,548.82 | $1,819.70 |
Moda Health Setting Facility Modifier None Typical Low $933.25 Median $3,162.28 Typical High $5,495.41 | Facility | None | $933.25 | $3,162.28 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,513.56 Median $2,089.30 Typical High $3,162.28 | Professional | None | $1,513.56 | $2,089.30 | $3,162.28 |
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 $1,621.81 Median $1,949.84 Typical High $1,949.84 | Facility | None | $1,621.81 | $1,949.84 | $1,949.84 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,137.96 | Professional | None | $1,949.84 | $1,949.84 | $2,137.96 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,905.46 Median $2,238.72 Typical High $2,238.72 | Professional | None | $1,905.46 | $2,238.72 | $2,238.72 |
Select Health Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $1,023.29 | Facility | None | $933.25 | $933.25 | $1,023.29 |
Select Health Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $2,041.74 | Professional | None | $933.25 | $933.25 | $2,041.74 |
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 $1,202.26 Median $1,548.82 Typical High $2,344.23 | Professional | None | $1,202.26 | $1,548.82 | $2,344.23 |
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 $630.96 Median $1,584.89 Typical High $1,584.89 | Professional | 52 · Reduced service | $630.96 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $630.96 Typical High $630.96 | Professional | 53 · Discontinued | $251.19 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $2,398.83 Typical High $2,398.83 | Professional | 54 · Surgery only | $933.25 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $478.63 Typical High $478.63 | Professional | 55 · Aftercare only | $186.21 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $316.23 Typical High $316.23 | Professional | 56 · Pre-op care only | $125.89 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $2,238.72 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $870.96 | $2,238.72 | $2,238.72 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $1,905.46 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,621.81 | $1,905.46 | $1,995.26 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $208.93 Typical High $218.78 | Professional | 55 · Aftercare only | $181.97 | $208.93 | $218.78 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,148.15 Median $1,318.26 Typical High $1,380.38 | Professional | 62 · Two surgeons | $1,148.15 | $1,318.26 | $1,380.38 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,187.76 Median $2,511.89 Typical High $2,630.27 | Professional | 63 · Small infant | $2,187.76 | $2,511.89 | $2,630.27 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,479.11 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,479.11 | $1,548.82 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $288.40 Median $338.84 Typical High $354.81 | Professional | 80 · Assistant surgeon | $288.40 | $338.84 | $354.81 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $288.40 Median $338.84 Typical High $354.81 | Professional | 81 · Minimal assistant surgeon | $288.40 | $338.84 | $354.81 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $288.40 Median $338.84 Typical High $354.81 | Professional | 82 · Assistant surgeon, no resident | $288.40 | $338.84 | $354.81 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $288.40 Typical High $302.00 | Professional | AS · PA/NP assist | $245.47 | $288.40 | $302.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $741.31 Median $1,584.89 Typical High $1,584.89 | Professional | 52 · Reduced service | $741.31 | $1,584.89 | $1,584.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $630.96 Typical High $630.96 | Professional | 53 · Discontinued | $302.00 | $630.96 | $630.96 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $2,398.83 Typical High $2,398.83 | Professional | 54 · Surgery only | $1,122.02 | $2,398.83 | $2,398.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $478.63 Typical High $478.63 | Professional | 55 · Aftercare only | $223.87 | $478.63 | $478.63 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $316.23 Typical High $316.23 | Professional | 56 · Pre-op care only | $151.36 | $316.23 | $316.23 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $2,238.72 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,047.13 | $2,238.72 | $2,238.72 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | 22 · Increased work | $2,344.23 | $2,344.23 | $2,344.23 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,479.11 | $1,479.11 | $1,479.11 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $213.80 | $213.80 | $213.80 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | 62 · Two surgeons | $1,318.26 | $1,318.26 | $1,318.26 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | 63 · Small infant | $2,344.23 | $2,344.23 | $2,344.23 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,584.89 | $1,584.89 |
Where Idaho sits
The same service costs 10.0 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 $17,294MD $1,737
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.