How much rates vary
Facilitymedian $1,862 · 10th to 90th $851 to $3,981Professionalmedian $1,230 · 10th to 90th $871 to $1,738
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 $977.24 Median $1,737.80 Typical High $1,737.80 | Professional | None | $977.24 | $1,737.80 | $1,737.80 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,995.26 Median $3,090.30 Typical High $4,168.69 | Facility | None | $1,995.26 | $3,090.30 | $4,168.69 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,174.90 Median $1,288.25 Typical High $1,513.56 | Professional | None | $1,174.90 | $1,288.25 | $1,513.56 |
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 $977.24 Median $1,122.02 Typical High $1,318.26 | Professional | None | $977.24 | $1,122.02 | $1,318.26 |
Moda Health Setting Facility Modifier None Typical Low $645.65 Median $1,737.80 Typical High $5,495.41 | Facility | None | $645.65 | $1,737.80 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $977.24 Median $1,380.38 Typical High $1,737.80 | Professional | None | $977.24 | $1,380.38 | $1,737.80 |
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 $1,348.96 Typical High $1,348.96 | Facility | None | $1,122.02 | $1,348.96 | $1,348.96 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,584.89 | Professional | None | $1,348.96 | $1,348.96 | $1,584.89 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,479.11 | Professional | None | $1,174.90 | $1,174.90 | $1,479.11 |
Select Health Setting Facility Modifier None Typical Low $645.65 Median $660.69 Typical High $2,630.27 | Facility | None | $645.65 | $660.69 | $2,630.27 |
Select Health Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,000.00 | Professional | None | $645.65 | $645.65 | $1,000.00 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $2,398.83 | Facility | None | $1,412.54 | $1,819.70 | $2,398.83 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,148.15 Typical High $1,659.59 | Professional | None | $776.25 | $1,148.15 | $1,659.59 |
21 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 $489.78 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $489.78 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $194.98 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $741.31 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $147.91 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $97.72 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $691.83 | $1,230.27 | $1,230.27 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,318.26 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,096.48 | $1,318.26 | $1,380.38 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $144.54 Typical High $151.36 | Professional | 55 · Aftercare only | $123.03 | $144.54 | $151.36 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $912.01 Typical High $954.99 | Professional | 62 · Two surgeons | $758.58 | $912.01 | $954.99 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,479.11 Median $1,737.80 Typical High $1,819.70 | Professional | 63 · Small infant | $1,479.11 | $1,737.80 | $1,819.70 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,023.29 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $851.14 | $1,023.29 | $1,071.52 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $234.42 Typical High $245.47 | Professional | 80 · Assistant surgeon | $194.98 | $234.42 | $245.47 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $194.98 Median $234.42 Typical High $245.47 | Professional | 81 · Minimal assistant surgeon | $194.98 | $234.42 | $245.47 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $194.98 Median $234.42 Typical High $245.47 | Professional | 82 · Assistant surgeon, no resident | $194.98 | $234.42 | $245.47 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $199.53 Typical High $208.93 | Professional | AS · PA/NP assist | $165.96 | $199.53 | $208.93 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $489.78 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $489.78 | $870.96 | $870.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $199.53 | $346.74 | $346.74 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $741.31 | $1,318.26 | $1,318.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $147.91 | $263.03 | $263.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $97.72 | $173.78 | $173.78 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $691.83 | $1,230.27 | $1,230.27 |
Where Idaho sits
The same service costs 7.8 times more in Maine than in Massachusetts. 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 $16,585MA $2,122
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.