How much rates vary
Facilitymedian $977 · 10th to 90th $550 to $4,571Professionalmedian $1,820 · 10th to 90th $1,230 to $2,291
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 $1,148.15 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,148.15 | $1,905.46 | $1,905.46 |
BCBS Idaho Setting Facility Modifier None Typical Low $4,073.80 Median $4,365.16 Typical High $5,248.07 | Facility | None | $4,073.80 | $4,365.16 | $5,248.07 |
BCBS Idaho 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 |
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 $1,380.38 Median $1,584.89 Typical High $1,862.09 | Professional | None | $1,380.38 | $1,584.89 | $1,862.09 |
Moda Health Setting Facility Modifier None Typical Low $977.24 Median $1,905.46 Typical High $5,495.41 | Facility | None | $977.24 | $1,905.46 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,905.46 Typical High $2,630.27 | Professional | None | $1,380.38 | $1,905.46 | $2,630.27 |
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 $1,659.59 Median $2,041.74 Typical High $2,041.74 | Facility | None | $1,659.59 | $2,041.74 | $2,041.74 |
MountainHealth Co-op 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 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $2,630.27 | Professional | None | $1,698.24 | $1,698.24 | $2,630.27 |
Select Health Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $1,047.13 | Facility | None | $977.24 | $977.24 | $1,047.13 |
Select Health Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,380.38 | Professional | None | $977.24 | $977.24 | $1,380.38 |
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 $1,122.02 Median $1,659.59 Typical High $2,344.23 | Professional | None | $1,122.02 | $1,659.59 | $2,344.23 |
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 $630.96 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $630.96 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $251.19 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $933.25 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $186.21 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $125.89 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $870.96 | $1,318.26 | $1,318.26 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,905.46 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,659.59 | $1,905.46 | $2,041.74 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $208.93 Typical High $229.09 | Professional | 55 · Aftercare only | $181.97 | $208.93 | $229.09 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,148.15 Median $1,318.26 Typical High $1,445.44 | Professional | 62 · Two surgeons | $1,148.15 | $1,318.26 | $1,445.44 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,187.76 Median $2,511.89 Typical High $2,754.23 | Professional | 63 · Small infant | $2,187.76 | $2,511.89 | $2,754.23 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,479.11 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,479.11 | $1,621.81 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $295.12 Median $338.84 Typical High $363.08 | Professional | 80 · Assistant surgeon | $295.12 | $338.84 | $363.08 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $295.12 Median $338.84 Typical High $363.08 | Professional | 81 · Minimal assistant surgeon | $295.12 | $338.84 | $363.08 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $295.12 Median $338.84 Typical High $363.08 | Professional | 82 · Assistant surgeon, no resident | $295.12 | $338.84 | $363.08 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $251.19 Median $288.40 Typical High $309.03 | Professional | AS · PA/NP assist | $251.19 | $288.40 | $309.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $691.83 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $691.83 | $954.99 | $954.99 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $275.42 | $380.19 | $380.19 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,047.13 | $1,412.54 | $1,412.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $208.93 | $281.84 | $281.84 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $138.04 | $190.55 | $190.55 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $977.24 | $1,318.26 | $1,318.26 |
Where Idaho sits
The same service costs 15.4 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 $28,500MD $1,851
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.