How much rates vary
Facilitymedian $1,318 · 10th to 90th $550 to $6,310Professionalmedian $1,905 · 10th to 90th $1,318 to $2,692
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 $4,365.16 Median $4,466.84 Typical High $8,511.38 | Facility | None | $4,365.16 | $4,466.84 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,548.82 Typical High $2,691.53 | Professional | None | $1,202.26 | $1,548.82 | $2,691.53 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,090.30 Median $3,388.44 Typical High $13,182.57 | Facility | None | $3,090.30 | $3,388.44 | $13,182.57 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,819.70 Median $1,995.26 Typical High $2,344.23 | Professional | None | $1,819.70 | $1,995.26 | $2,344.23 |
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 $1,513.56 Median $1,737.80 Typical High $2,041.74 | Professional | None | $1,513.56 | $1,737.80 | $2,041.74 |
Moda Health Setting Facility Modifier None Typical Low $1,318.26 Median $3,890.45 Typical High $12,022.64 | Facility | None | $1,318.26 | $3,890.45 | $12,022.64 |
Moda Health Setting Professional Modifier None Typical Low $1,412.54 Median $2,137.96 Typical High $2,691.53 | Professional | None | $1,412.54 | $2,137.96 | $2,691.53 |
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 $1,698.24 Median $2,089.30 Typical High $2,089.30 | Facility | None | $1,698.24 | $2,089.30 | $2,089.30 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,398.83 | Professional | None | $2,089.30 | $2,089.30 | $2,398.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,290.87 | Professional | None | $1,819.70 | $1,819.70 | $2,290.87 |
Select Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,047.13 | Facility | None | $1,000.00 | $1,000.00 | $1,047.13 |
Select Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,548.82 | Professional | None | $1,000.00 | $1,000.00 | $1,548.82 |
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 $1,737.80 Typical High $2,570.40 | Professional | None | $1,202.26 | $1,737.80 | $2,570.40 |
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 $758.58 Median $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $758.58 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $549.54 Typical High $549.54 | Professional | 53 · Discontinued | $302.00 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $2,041.74 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,148.15 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $407.38 Typical High $407.38 | Professional | 55 · Aftercare only | $229.09 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $151.36 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,905.46 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,905.46 | $1,905.46 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $2,818.38 Median $3,388.44 Typical High $3,548.13 | Professional | 50 · Both sides | $2,818.38 | $3,388.44 | $3,548.13 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $2,041.74 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,698.24 | $2,041.74 | $2,137.96 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $223.87 Typical High $234.42 | Professional | 55 · Aftercare only | $190.55 | $223.87 | $234.42 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,174.90 Median $1,412.54 Typical High $1,479.11 | Professional | 62 · Two surgeons | $1,174.90 | $1,412.54 | $1,479.11 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,290.87 Median $2,691.53 Typical High $2,818.38 | Professional | 63 · Small infant | $2,290.87 | $2,691.53 | $2,818.38 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,584.89 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,584.89 | $1,659.59 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $363.08 Typical High $380.19 | Professional | 80 · Assistant surgeon | $302.00 | $363.08 | $380.19 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $302.00 Median $363.08 Typical High $380.19 | Professional | 81 · Minimal assistant surgeon | $302.00 | $363.08 | $380.19 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $302.00 Median $363.08 Typical High $380.19 | Professional | 82 · Assistant surgeon, no resident | $302.00 | $363.08 | $380.19 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $257.04 Median $309.03 Typical High $323.59 | Professional | AS · PA/NP assist | $257.04 | $309.03 | $323.59 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $776.25 Median $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $776.25 | $1,348.96 | $1,348.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $549.54 Typical High $549.54 | Professional | 53 · Discontinued | $309.03 | $549.54 | $549.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $2,041.74 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,148.15 | $2,041.74 | $2,041.74 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $407.38 Typical High $407.38 | Professional | 55 · Aftercare only | $229.09 | $407.38 | $407.38 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $154.88 | $269.15 | $269.15 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,905.46 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,905.46 | $1,905.46 |
Where Idaho sits
The same service costs 14.8 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 $28,001MD $1,894
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.