How much rates vary
Facilitymedian $1,698 · 10th to 90th $550 to $7,586Professionalmedian $3,548 · 10th to 90th $2,188 to $4,571
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 $1,995.26 Median $4,570.88 Typical High $4,570.88 | Professional | None | $1,995.26 | $4,570.88 | $4,570.88 |
BCBS Idaho Setting Facility Modifier None Typical Low $6,918.31 Median $7,413.10 Typical High $8,912.51 | Facility | None | $6,918.31 | $7,413.10 | $8,912.51 |
BCBS Idaho Setting Professional Modifier None Typical Low $3,311.31 Median $3,890.45 Typical High $4,073.80 | Professional | None | $3,311.31 | $3,890.45 | $4,073.80 |
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 $2,344.23 Median $2,818.38 Typical High $3,235.94 | Professional | None | $2,344.23 | $2,818.38 | $3,235.94 |
Moda Health Setting Facility Modifier None Typical Low $1,698.24 Median $4,570.88 Typical High $6,606.93 | Facility | None | $1,698.24 | $4,570.88 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $2,454.71 Median $3,890.45 Typical High $4,570.88 | Professional | None | $2,454.71 | $3,890.45 | $4,570.88 |
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 $2,884.03 Median $3,548.13 Typical High $3,548.13 | Facility | None | $2,884.03 | $3,548.13 | $3,548.13 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $4,466.84 | Professional | None | $3,548.13 | $3,548.13 | $4,466.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,388.44 Median $4,073.80 Typical High $4,570.88 | Professional | None | $3,388.44 | $4,073.80 | $4,570.88 |
Select Health Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,862.09 | Facility | None | $1,698.24 | $1,698.24 | $1,862.09 |
Select Health Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $2,398.83 | Professional | None | $1,698.24 | $1,698.24 | $2,398.83 |
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 $1,949.84 Median $2,884.03 Typical High $4,265.80 | Professional | None | $1,949.84 | $2,884.03 | $4,265.80 |
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 $1,202.26 Median $2,290.87 Typical High $2,290.87 | Professional | 52 · Reduced service | $1,202.26 | $2,290.87 | $2,290.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $912.01 Typical High $912.01 | Professional | 53 · Discontinued | $489.78 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $3,467.37 Typical High $3,467.37 | Professional | 54 · Surgery only | $1,819.70 | $3,467.37 | $3,467.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $691.83 Typical High $691.83 | Professional | 55 · Aftercare only | $363.08 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $457.09 Typical High $457.09 | Professional | 56 · Pre-op care only | $245.47 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $3,235.94 Typical High $3,235.94 | Professional | 78 · Unplanned return to OR | $1,698.24 | $3,235.94 | $3,235.94 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,884.03 Median $3,311.31 Typical High $3,548.13 | Professional | 54 · Surgery only | $2,884.03 | $3,311.31 | $3,548.13 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $363.08 Typical High $398.11 | Professional | 55 · Aftercare only | $316.23 | $363.08 | $398.11 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,995.26 Median $2,290.87 Typical High $2,511.89 | Professional | 62 · Two surgeons | $1,995.26 | $2,290.87 | $2,511.89 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $3,801.89 Median $4,365.16 Typical High $4,786.30 | Professional | 63 · Small infant | $3,801.89 | $4,365.16 | $4,786.30 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,238.72 Median $2,570.40 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $2,238.72 | $2,570.40 | $2,818.38 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $512.86 Median $588.84 Typical High $630.96 | Professional | 80 · Assistant surgeon | $512.86 | $588.84 | $630.96 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $512.86 Median $588.84 Typical High $630.96 | Professional | 81 · Minimal assistant surgeon | $512.86 | $588.84 | $630.96 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $512.86 Median $588.84 Typical High $630.96 | Professional | 82 · Assistant surgeon, no resident | $512.86 | $588.84 | $630.96 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $436.52 Median $501.19 Typical High $537.03 | Professional | AS · PA/NP assist | $436.52 | $501.19 | $537.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,202.26 Median $2,290.87 Typical High $2,290.87 | Professional | 52 · Reduced service | $1,202.26 | $2,290.87 | $2,290.87 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $912.01 Typical High $912.01 | Professional | 53 · Discontinued | $489.78 | $912.01 | $912.01 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $3,467.37 Typical High $3,467.37 | Professional | 54 · Surgery only | $1,819.70 | $3,467.37 | $3,467.37 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $691.83 Typical High $691.83 | Professional | 55 · Aftercare only | $363.08 | $691.83 | $691.83 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $457.09 Typical High $457.09 | Professional | 56 · Pre-op care only | $245.47 | $457.09 | $457.09 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $3,235.94 Typical High $3,235.94 | Professional | 78 · Unplanned return to OR | $1,698.24 | $3,235.94 | $3,235.94 |
Where Idaho sits
The same service costs 13.8 times more in Maine than in Washington. 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 $35,114WA $2,549
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.