How much rates vary
Facilitymedian $1,122 · 10th to 90th $550 to $4,571Professionalmedian $2,138 · 10th to 90th $1,479 to $3,020
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 $1,380.38 Median $3,019.95 Typical High $3,019.95 | Professional | None | $1,380.38 | $3,019.95 | $3,019.95 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,467.37 Median $3,715.35 Typical High $4,897.79 | Facility | None | $3,467.37 | $3,715.35 | $4,897.79 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,041.74 Median $2,238.72 Typical High $2,630.27 | Professional | None | $2,041.74 | $2,238.72 | $2,630.27 |
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 $1,698.24 Median $1,949.84 Typical High $2,290.87 | Professional | None | $1,698.24 | $1,949.84 | $2,290.87 |
Moda Health Setting Facility Modifier None Typical Low $1,548.82 Median $3,019.95 Typical High $5,495.41 | Facility | None | $1,548.82 | $3,019.95 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $3,019.95 | Professional | None | $1,698.24 | $2,511.89 | $3,019.95 |
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 $1,905.46 Median $2,344.23 Typical High $2,344.23 | Facility | None | $1,905.46 | $2,344.23 | $2,344.23 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,691.53 | Professional | None | $2,344.23 | $2,344.23 | $2,691.53 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,570.40 | Professional | None | $2,041.74 | $2,041.74 | $2,570.40 |
Select Health Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,174.90 | Facility | None | $1,122.02 | $1,122.02 | $1,174.90 |
Select Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,698.24 | Professional | None | $1,122.02 | $1,122.02 | $1,698.24 |
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 $1,380.38 Median $1,949.84 Typical High $2,884.03 | Professional | None | $1,380.38 | $1,949.84 | $2,884.03 |
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 $851.14 Median $1,513.56 Typical High $1,513.56 | Professional | 52 · Reduced service | $851.14 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $602.56 Typical High $602.56 | Professional | 53 · Discontinued | $338.84 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $2,290.87 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,258.93 | $2,290.87 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $457.09 Typical High $457.09 | Professional | 55 · Aftercare only | $251.19 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $302.00 Typical High $302.00 | Professional | 56 · Pre-op care only | $169.82 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $2,137.96 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,174.90 | $2,137.96 | $2,137.96 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $3,162.28 Median $3,715.35 Typical High $3,890.45 | Professional | 50 · Both sides | $3,162.28 | $3,715.35 | $3,890.45 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $2,238.72 Typical High $2,344.23 | Professional | 54 · Surgery only | $1,905.46 | $2,238.72 | $2,344.23 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $251.19 Typical High $263.03 | Professional | 55 · Aftercare only | $208.93 | $251.19 | $263.03 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,318.26 Median $1,548.82 Typical High $1,621.81 | Professional | 62 · Two surgeons | $1,318.26 | $1,548.82 | $1,621.81 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,511.89 Median $3,019.95 Typical High $3,162.28 | Professional | 63 · Small infant | $2,511.89 | $3,019.95 | $3,162.28 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,737.80 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,737.80 | $1,819.70 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $338.84 Median $398.11 Typical High $416.87 | Professional | 80 · Assistant surgeon | $338.84 | $398.11 | $416.87 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $338.84 Median $398.11 Typical High $416.87 | Professional | 81 · Minimal assistant surgeon | $338.84 | $398.11 | $416.87 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $338.84 Median $398.11 Typical High $416.87 | Professional | 82 · Assistant surgeon, no resident | $338.84 | $398.11 | $416.87 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $288.40 Median $338.84 Typical High $354.81 | Professional | AS · PA/NP assist | $288.40 | $338.84 | $354.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $851.14 Median $1,513.56 Typical High $1,513.56 | Professional | 52 · Reduced service | $851.14 | $1,513.56 | $1,513.56 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $602.56 Typical High $602.56 | Professional | 53 · Discontinued | $338.84 | $602.56 | $602.56 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $2,290.87 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,288.25 | $2,290.87 | $2,290.87 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $457.09 Typical High $457.09 | Professional | 55 · Aftercare only | $257.04 | $457.09 | $457.09 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $302.00 Typical High $302.00 | Professional | 56 · Pre-op care only | $169.82 | $302.00 | $302.00 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $2,137.96 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,202.26 | $2,137.96 | $2,137.96 |
Where Idaho sits
The same service costs 13.9 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 $28,165MD $2,021
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.