How much rates vary
Facilitymedian $1,072 · 10th to 90th $550 to $5,248Professionalmedian $2,042 · 10th to 90th $1,445 to $2,884
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 $2,884.03 Typical High $2,884.03 | Professional | None | $1,318.26 | $2,884.03 | $2,884.03 |
BCBS Idaho Setting Facility Modifier None Typical Low $4,570.88 Median $5,011.87 Typical High $6,025.60 | Facility | None | $4,570.88 | $5,011.87 | $6,025.60 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,949.84 Median $2,137.96 Typical High $2,511.89 | Professional | None | $1,949.84 | $2,137.96 | $2,511.89 |
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 $1,621.81 Median $1,862.09 Typical High $2,187.76 | Professional | None | $1,621.81 | $1,862.09 | $2,187.76 |
Moda Health Setting Facility Modifier None Typical Low $1,071.52 Median $2,884.03 Typical High $5,495.41 | Facility | None | $1,071.52 | $2,884.03 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,621.81 Median $2,344.23 Typical High $2,884.03 | Professional | None | $1,621.81 | $2,344.23 | $2,884.03 |
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 $1,819.70 Median $2,238.72 Typical High $2,238.72 | Facility | None | $1,819.70 | $2,238.72 | $2,238.72 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,570.40 | Professional | None | $2,238.72 | $2,238.72 | $2,570.40 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,454.71 | Professional | None | $1,949.84 | $1,949.84 | $2,454.71 |
Select Health Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,122.02 | Facility | None | $1,071.52 | $1,071.52 | $1,122.02 |
Select Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,621.81 | Professional | None | $1,071.52 | $1,071.52 | $1,621.81 |
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 $1,288.25 Median $1,862.09 Typical High $2,754.23 | Professional | None | $1,288.25 | $1,862.09 | $2,754.23 |
22 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 $812.83 Median $1,445.44 Typical High $1,445.44 | Professional | 52 · Reduced service | $812.83 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $575.44 Typical High $575.44 | Professional | 53 · Discontinued | $323.59 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $2,187.76 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,202.26 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $436.52 Typical High $436.52 | Professional | 55 · Aftercare only | $239.88 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $288.40 Typical High $288.40 | Professional | 56 · Pre-op care only | $162.18 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $2,041.74 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,122.02 | $2,041.74 | $2,041.74 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $3,019.95 Median $3,548.13 Typical High $3,715.35 | Professional | 50 · Both sides | $3,019.95 | $3,548.13 | $3,715.35 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $2,137.96 Typical High $2,238.72 | Professional | 54 · Surgery only | $1,819.70 | $2,137.96 | $2,238.72 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $239.88 Typical High $251.19 | Professional | 55 · Aftercare only | $199.53 | $239.88 | $251.19 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,258.93 Median $1,479.11 Typical High $1,548.82 | Professional | 62 · Two surgeons | $1,258.93 | $1,479.11 | $1,548.82 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,398.83 Median $2,884.03 Typical High $3,019.95 | Professional | 63 · Small infant | $2,398.83 | $2,884.03 | $3,019.95 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,659.59 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,659.59 | $1,737.80 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $323.59 Median $380.19 Typical High $398.11 | Professional | 80 · Assistant surgeon | $323.59 | $380.19 | $398.11 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $323.59 Median $380.19 Typical High $398.11 | Professional | 81 · Minimal assistant surgeon | $323.59 | $380.19 | $398.11 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $323.59 Median $380.19 Typical High $398.11 | Professional | 82 · Assistant surgeon, no resident | $323.59 | $380.19 | $398.11 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $275.42 Median $323.59 Typical High $338.84 | Professional | AS · PA/NP assist | $275.42 | $323.59 | $338.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $812.83 Median $1,445.44 Typical High $1,445.44 | Professional | 52 · Reduced service | $812.83 | $1,445.44 | $1,445.44 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $575.44 Typical High $575.44 | Professional | 53 · Discontinued | $323.59 | $575.44 | $575.44 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $2,187.76 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,230.27 | $2,187.76 | $2,187.76 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $436.52 Typical High $436.52 | Professional | 55 · Aftercare only | $245.47 | $436.52 | $436.52 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $288.40 Typical High $288.40 | Professional | 56 · Pre-op care only | $162.18 | $288.40 | $288.40 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $2,041.74 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,148.15 | $2,041.74 | $2,041.74 |
Where Idaho sits
The same service costs 12.5 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 $24,646MD $1,975
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.