How much rates vary
Facilitymedian $851 · 10th to 90th $550 to $3,388Professionalmedian $1,380 · 10th to 90th $851 to $2,188
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 $831.76 Median $2,187.76 Typical High $2,187.76 | Professional | None | $831.76 | $2,187.76 | $2,187.76 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,905.46 Median $2,818.38 Typical High $3,388.44 | Facility | None | $1,905.46 | $2,818.38 | $3,388.44 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,288.25 Median $1,479.11 Typical High $1,548.82 | Professional | None | $1,288.25 | $1,479.11 | $1,548.82 |
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 $891.25 Median $1,096.48 Typical High $1,258.93 | Professional | None | $891.25 | $1,096.48 | $1,258.93 |
Moda Health Setting Facility Modifier None Typical Low $660.69 Median $2,187.76 Typical High $5,495.41 | Facility | None | $660.69 | $2,187.76 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,445.44 Typical High $2,187.76 | Professional | None | $1,047.13 | $1,445.44 | $2,187.76 |
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 $1,122.02 Median $1,380.38 Typical High $1,380.38 | Facility | None | $1,122.02 | $1,380.38 | $1,380.38 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,479.11 | Professional | None | $1,380.38 | $1,380.38 | $1,479.11 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,318.26 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,318.26 | $1,548.82 | $1,548.82 |
Select Health Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $707.95 | Facility | None | $660.69 | $660.69 | $707.95 |
Select Health Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,412.54 | Professional | None | $660.69 | $660.69 | $1,412.54 |
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 $812.83 Median $1,047.13 Typical High $1,584.89 | Professional | None | $812.83 | $1,047.13 | $1,584.89 |
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 $416.87 Median $1,096.48 Typical High $1,096.48 | Professional | 52 · Reduced service | $416.87 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $165.96 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $1,659.59 Typical High $1,659.59 | Professional | 54 · Surgery only | $630.96 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $331.13 Typical High $331.13 | Professional | 55 · Aftercare only | $125.89 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $83.18 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $1,548.82 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $588.84 | $1,548.82 | $1,548.82 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,318.26 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,148.15 | $1,318.26 | $1,380.38 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $147.91 Typical High $154.88 | Professional | 55 · Aftercare only | $128.82 | $147.91 | $154.88 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $794.33 Median $912.01 Typical High $977.24 | Professional | 62 · Two surgeons | $794.33 | $912.01 | $977.24 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,548.82 Median $1,778.28 Typical High $1,862.09 | Professional | 63 · Small infant | $1,548.82 | $1,778.28 | $1,862.09 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,023.29 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $891.25 | $1,023.29 | $1,096.48 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $234.42 Typical High $245.47 | Professional | 80 · Assistant surgeon | $204.17 | $234.42 | $245.47 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $204.17 Median $234.42 Typical High $245.47 | Professional | 81 · Minimal assistant surgeon | $204.17 | $234.42 | $245.47 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $204.17 Median $234.42 Typical High $245.47 | Professional | 82 · Assistant surgeon, no resident | $204.17 | $234.42 | $245.47 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $199.53 Typical High $208.93 | Professional | AS · PA/NP assist | $173.78 | $199.53 | $208.93 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $524.81 Median $1,096.48 Typical High $1,096.48 | Professional | 52 · Reduced service | $524.81 | $1,096.48 | $1,096.48 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $208.93 | $436.52 | $436.52 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $1,659.59 Typical High $1,659.59 | Professional | 54 · Surgery only | $776.25 | $1,659.59 | $1,659.59 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $331.13 Typical High $331.13 | Professional | 55 · Aftercare only | $158.49 | $331.13 | $331.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $104.71 | $218.78 | $218.78 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $1,548.82 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $724.44 | $1,548.82 | $1,548.82 |
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | 22 · Increased work | $1,621.81 | $1,621.81 | $1,621.81 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $1,023.29 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $147.91 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | 62 · Two surgeons | $912.01 | $912.01 | $912.01 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | 63 · Small infant | $1,621.81 | $1,621.81 | $1,621.81 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,096.48 | $1,096.48 |
Where Idaho sits
The same service costs 12.3 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 $16,849MD $1,375
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.