How much rates vary
Facilitymedian $1,349 · 10th to 90th $550 to $6,310Professionalmedian $2,818 · 10th to 90th $1,622 to $4,571
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 $1,513.56 Median $4,570.88 Typical High $4,570.88 | Professional | None | $1,513.56 | $4,570.88 | $4,570.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $3,467.37 Typical High $3,467.37 | Professional | 54 · Surgery only | $1,348.96 | $3,467.37 | $3,467.37 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $3,235.94 Typical High $3,235.94 | Professional | 78 · Unplanned return to OR | $1,258.93 | $3,235.94 | $3,235.94 |
BCBS Idaho Setting Facility Modifier None Typical Low $4,168.69 Median $6,025.60 Typical High $7,244.36 | Facility | None | $4,168.69 | $6,025.60 | $7,244.36 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,630.27 Median $3,019.95 Typical High $3,162.28 | Professional | None | $2,630.27 | $3,019.95 | $3,162.28 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,344.23 Median $2,691.53 Typical High $2,818.38 | Professional | 54 · Surgery only | $2,344.23 | $2,691.53 | $2,818.38 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $2,089.30 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $1,819.70 | $2,089.30 | $2,187.76 |
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 $1,905.46 Median $2,238.72 Typical High $2,630.27 | Professional | None | $1,905.46 | $2,238.72 | $2,630.27 |
Moda Health Setting Facility Modifier None Typical Low $1,348.96 Median $4,570.88 Typical High $6,606.93 | Facility | None | $1,348.96 | $4,570.88 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $1,584.89 Median $3,019.95 Typical High $4,570.88 | Professional | None | $1,584.89 | $3,019.95 | $4,570.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $3,467.37 Typical High $3,467.37 | Professional | 54 · Surgery only | $1,621.81 | $3,467.37 | $3,467.37 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $3,235.94 Typical High $3,235.94 | Professional | 78 · Unplanned return to OR | $1,513.56 | $3,235.94 | $3,235.94 |
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 $2,290.87 Median $2,818.38 Typical High $2,818.38 | Facility | None | $2,290.87 | $2,818.38 | $2,818.38 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $3,019.95 | Professional | None | $2,818.38 | $2,818.38 | $3,019.95 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Professional | 54 · Surgery only | $2,137.96 | $2,137.96 | $2,137.96 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $2,290.87 | $2,290.87 | $2,290.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,691.53 Median $3,162.28 Typical High $3,162.28 | Professional | None | $2,691.53 | $3,162.28 | $3,162.28 |
Select Health Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,445.44 | Facility | None | $1,348.96 | $1,348.96 | $1,445.44 |
Select Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $2,951.21 | Professional | None | $1,348.96 | $1,348.96 | $2,951.21 |
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 $1,698.24 Median $2,238.72 Typical High $3,388.44 | Professional | None | $1,698.24 | $2,238.72 | $3,388.44 |
17 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 $891.25 Median $2,290.87 Typical High $2,290.87 | Professional | 52 · Reduced service | $891.25 | $2,290.87 | $2,290.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $912.01 Typical High $912.01 | Professional | 53 · Discontinued | $363.08 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $691.83 Typical High $691.83 | Professional | 55 · Aftercare only | $269.15 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $457.09 Typical High $457.09 | Professional | 56 · Pre-op care only | $181.97 | $457.09 | $457.09 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $302.00 Typical High $316.23 | Professional | 55 · Aftercare only | $263.03 | $302.00 | $316.23 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $3,090.30 Median $3,630.78 Typical High $3,801.89 | Professional | 63 · Small infant | $3,090.30 | $3,630.78 | $3,801.89 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $416.87 Median $478.63 Typical High $501.19 | Professional | 80 · Assistant surgeon | $416.87 | $478.63 | $501.19 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $416.87 Median $478.63 Typical High $501.19 | Professional | 81 · Minimal assistant surgeon | $416.87 | $478.63 | $501.19 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $416.87 Median $478.63 Typical High $501.19 | Professional | 82 · Assistant surgeon, no resident | $416.87 | $478.63 | $501.19 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $354.81 Median $407.38 Typical High $426.58 | Professional | AS · PA/NP assist | $354.81 | $407.38 | $426.58 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,071.52 Median $2,290.87 Typical High $2,290.87 | Professional | 52 · Reduced service | $1,071.52 | $2,290.87 | $2,290.87 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $912.01 Typical High $912.01 | Professional | 53 · Discontinued | $426.58 | $912.01 | $912.01 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $691.83 Typical High $691.83 | Professional | 55 · Aftercare only | $323.59 | $691.83 | $691.83 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $457.09 Typical High $457.09 | Professional | 56 · Pre-op care only | $213.80 | $457.09 | $457.09 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Professional | 22 · Increased work | $3,311.31 | $3,311.31 | $3,311.31 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 56 · Pre-op care only | $302.00 | $302.00 | $302.00 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Professional | 63 · Small infant | $3,311.31 | $3,311.31 | $3,311.31 |
Where Idaho sits
The same service costs 8.1 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 $17,891MD $2,222
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.