How much rates vary
Facilitymedian $1,862 · 10th to 90th $933 to $5,495Professionalmedian $1,259 · 10th to 90th $851 to $1,585
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 $794.33 Median $1,148.15 Typical High $1,380.38 | Professional | None | $794.33 | $1,148.15 | $1,380.38 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,819.70 Median $2,951.21 Typical High $11,220.18 | Facility | None | $1,819.70 | $2,951.21 | $11,220.18 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,230.27 Median $1,348.96 Typical High $1,584.89 | Professional | None | $1,230.27 | $1,348.96 | $1,584.89 |
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 $977.24 Median $1,148.15 Typical High $1,348.96 | Professional | None | $977.24 | $1,148.15 | $1,348.96 |
Moda Health Setting Facility Modifier None Typical Low $831.76 Median $1,380.38 Typical High $5,495.41 | Facility | None | $831.76 | $1,380.38 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $933.25 Median $1,380.38 Typical High $1,621.81 | Professional | None | $933.25 | $1,380.38 | $1,621.81 |
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 $1,148.15 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,148.15 | $1,412.54 | $1,412.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,659.59 | Professional | None | $1,412.54 | $1,412.54 | $1,659.59 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,548.82 | Professional | None | $1,230.27 | $1,230.27 | $1,548.82 |
Select Health Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $2,137.96 | Facility | None | $676.08 | $676.08 | $2,137.96 |
Select Health Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $1,023.29 | Professional | None | $676.08 | $676.08 | $1,023.29 |
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 $1,122.02 Typical High $1,584.89 | Professional | None | $776.25 | $1,122.02 | $1,584.89 |
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 $457.09 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $457.09 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $186.21 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $691.83 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $138.04 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $93.33 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $645.65 | $977.24 | $977.24 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,348.96 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,122.02 | $1,348.96 | $1,412.54 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $147.91 Typical High $158.49 | Professional | 55 · Aftercare only | $125.89 | $147.91 | $158.49 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $794.33 Median $933.25 Typical High $977.24 | Professional | 62 · Two surgeons | $794.33 | $933.25 | $977.24 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,513.56 Median $1,778.28 Typical High $1,905.46 | Professional | 63 · Small infant | $1,513.56 | $1,778.28 | $1,905.46 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,047.13 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $891.25 | $1,047.13 | $1,096.48 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $239.88 Typical High $251.19 | Professional | 80 · Assistant surgeon | $199.53 | $239.88 | $251.19 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $199.53 Median $239.88 Typical High $251.19 | Professional | 81 · Minimal assistant surgeon | $199.53 | $239.88 | $251.19 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $199.53 Median $239.88 Typical High $251.19 | Professional | 82 · Assistant surgeon, no resident | $199.53 | $239.88 | $251.19 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $204.17 Typical High $213.80 | Professional | AS · PA/NP assist | $169.82 | $204.17 | $213.80 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $457.09 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $457.09 | $691.83 | $691.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $186.21 | $275.42 | $275.42 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $691.83 | $1,047.13 | $1,047.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $138.04 | $208.93 | $208.93 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $93.33 | $138.04 | $138.04 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $645.65 | $977.24 | $977.24 |
Where Idaho sits
The same service costs 11.6 times more in Maine than in Texas. 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 $23,484TX $2,029
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.