How much rates vary
Facilitymedian $1,148 · 10th to 90th $550 to $5,623Professionalmedian $2,188 · 10th to 90th $1,549 to $3,162
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 $1,698.24 Median $3,162.28 Typical High $3,162.28 | Professional | None | $1,698.24 | $3,162.28 | $3,162.28 |
BCBS Idaho Setting Facility Modifier None Typical Low $5,011.87 Median $5,370.32 Typical High $6,606.93 | Facility | None | $5,011.87 | $5,370.32 | $6,606.93 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,089.30 Median $2,290.87 Typical High $2,691.53 | Professional | None | $2,089.30 | $2,290.87 | $2,691.53 |
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 $1,737.80 Median $1,995.26 Typical High $2,398.83 | Professional | None | $1,737.80 | $1,995.26 | $2,398.83 |
Moda Health Setting Facility Modifier None Typical Low $1,148.15 Median $3,162.28 Typical High $5,495.41 | Facility | None | $1,148.15 | $3,162.28 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,570.40 Typical High $3,162.28 | Professional | None | $1,778.28 | $2,570.40 | $3,162.28 |
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 $1,995.26 Median $2,398.83 Typical High $2,398.83 | Facility | None | $1,995.26 | $2,398.83 | $2,398.83 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,754.23 | Professional | None | $2,398.83 | $2,398.83 | $2,754.23 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,630.27 | Professional | None | $2,089.30 | $2,089.30 | $2,630.27 |
Select Health Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,202.26 | Facility | None | $1,148.15 | $1,148.15 | $1,202.26 |
Select Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,778.28 | Professional | None | $1,148.15 | $1,148.15 | $1,778.28 |
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 $2,041.74 Typical High $2,951.21 | Professional | None | $1,380.38 | $2,041.74 | $2,951.21 |
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 $870.96 Median $1,584.89 Typical High $1,584.89 | Professional | 52 · Reduced service | $870.96 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $630.96 Typical High $630.96 | Professional | 53 · Discontinued | $346.74 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $2,344.23 Typical High $2,344.23 | Professional | 54 · Surgery only | $1,318.26 | $2,344.23 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $467.74 Typical High $467.74 | Professional | 55 · Aftercare only | $263.03 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $316.23 Typical High $316.23 | Professional | 56 · Pre-op care only | $173.78 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $2,187.76 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $1,230.27 | $2,187.76 | $2,187.76 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $2,344.23 Typical High $2,454.71 | Professional | 54 · Surgery only | $1,949.84 | $2,344.23 | $2,454.71 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $257.04 Typical High $269.15 | Professional | 55 · Aftercare only | $218.78 | $257.04 | $269.15 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,348.96 Median $1,621.81 Typical High $1,698.24 | Professional | 62 · Two surgeons | $1,348.96 | $1,621.81 | $1,698.24 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,630.27 Median $3,090.30 Typical High $3,235.94 | Professional | 63 · Small infant | $2,630.27 | $3,090.30 | $3,235.94 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,819.70 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,819.70 | $1,905.46 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $346.74 Median $416.87 Typical High $436.52 | Professional | 80 · Assistant surgeon | $346.74 | $416.87 | $436.52 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $346.74 Median $416.87 Typical High $436.52 | Professional | 81 · Minimal assistant surgeon | $346.74 | $416.87 | $436.52 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $346.74 Median $416.87 Typical High $436.52 | Professional | 82 · Assistant surgeon, no resident | $346.74 | $416.87 | $436.52 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $295.12 Median $354.81 Typical High $371.54 | Professional | AS · PA/NP assist | $295.12 | $354.81 | $371.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $891.25 Median $1,584.89 Typical High $1,584.89 | Professional | 52 · Reduced service | $891.25 | $1,584.89 | $1,584.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $630.96 Typical High $630.96 | Professional | 53 · Discontinued | $354.81 | $630.96 | $630.96 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $2,344.23 Typical High $2,344.23 | Professional | 54 · Surgery only | $1,318.26 | $2,344.23 | $2,344.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $467.74 Typical High $467.74 | Professional | 55 · Aftercare only | $263.03 | $467.74 | $467.74 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $316.23 Typical High $316.23 | Professional | 56 · Pre-op care only | $177.83 | $316.23 | $316.23 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $2,187.76 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $1,230.27 | $2,187.76 | $2,187.76 |
Where Idaho sits
The same service costs 12.0 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 $24,859MD $2,076
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.