How much rates vary
Facilitymedian $2,630 · 10th to 90th $550 to $12,303Professionalmedian $5,495 · 10th to 90th $3,548 to $7,244
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 $3,801.89 Median $7,244.36 Typical High $7,244.36 | Professional | None | $3,801.89 | $7,244.36 | $7,244.36 |
BCBS Idaho Setting Facility Modifier None Typical Low $10,964.78 Median $11,748.98 Typical High $14,125.38 | Facility | None | $10,964.78 | $11,748.98 | $14,125.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $5,011.87 Median $5,888.44 Typical High $6,456.54 | Professional | None | $5,011.87 | $5,888.44 | $6,456.54 |
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 $3,715.35 Median $4,466.84 Typical High $5,128.61 | Professional | None | $3,715.35 | $4,466.84 | $5,128.61 |
Moda Health Setting Facility Modifier None Typical Low $2,630.27 Median $5,495.41 Typical High $10,471.29 | Facility | None | $2,630.27 | $5,495.41 | $10,471.29 |
Moda Health Setting Professional Modifier None Typical Low $3,801.89 Median $6,456.54 Typical High $7,244.36 | Professional | None | $3,801.89 | $6,456.54 | $7,244.36 |
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 $4,466.84 Median $5,495.41 Typical High $5,495.41 | Facility | None | $4,466.84 | $5,495.41 | $5,495.41 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $6,918.31 | Professional | None | $5,495.41 | $5,495.41 | $6,918.31 |
Regence BlueShield Setting Professional Modifier None Typical Low $5,370.32 Median $6,456.54 Typical High $7,244.36 | Professional | None | $5,370.32 | $6,456.54 | $7,244.36 |
Select Health Setting Facility Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,884.03 | Facility | None | $2,630.27 | $2,630.27 | $2,884.03 |
Select Health Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $3,801.89 | Professional | None | $2,630.27 | $2,630.27 | $3,801.89 |
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 $3,162.28 Median $4,570.88 Typical High $6,760.83 | Professional | None | $3,162.28 | $4,570.88 | $6,760.83 |
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 $1,905.46 Median $3,630.78 Typical High $3,630.78 | Professional | 52 · Reduced service | $1,905.46 | $3,630.78 | $3,630.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $776.25 Median $1,445.44 Typical High $1,445.44 | Professional | 53 · Discontinued | $776.25 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,884.03 Median $5,495.41 Typical High $5,495.41 | Professional | 54 · Surgery only | $2,884.03 | $5,495.41 | $5,495.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $575.44 Median $1,096.48 Typical High $1,096.48 | Professional | 55 · Aftercare only | $575.44 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $380.19 Median $724.44 Typical High $724.44 | Professional | 56 · Pre-op care only | $380.19 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,691.53 Median $5,128.61 Typical High $5,128.61 | Professional | 78 · Unplanned return to OR | $2,691.53 | $5,128.61 | $5,128.61 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $4,466.84 Median $5,128.61 Typical High $5,495.41 | Professional | 54 · Surgery only | $4,466.84 | $5,128.61 | $5,495.41 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $489.78 Median $575.44 Typical High $616.60 | Professional | 55 · Aftercare only | $489.78 | $575.44 | $616.60 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $3,090.30 Median $3,548.13 Typical High $3,801.89 | Professional | 62 · Two surgeons | $3,090.30 | $3,548.13 | $3,801.89 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $5,888.44 Median $6,918.31 Typical High $7,413.10 | Professional | 63 · Small infant | $5,888.44 | $6,918.31 | $7,413.10 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,467.37 Median $3,981.07 Typical High $4,265.80 | Professional | 78 · Unplanned return to OR | $3,467.37 | $3,981.07 | $4,265.80 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $794.33 Median $912.01 Typical High $977.24 | Professional | 80 · Assistant surgeon | $794.33 | $912.01 | $977.24 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $794.33 Median $912.01 Typical High $977.24 | Professional | 81 · Minimal assistant surgeon | $794.33 | $912.01 | $977.24 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $794.33 Median $912.01 Typical High $977.24 | Professional | 82 · Assistant surgeon, no resident | $794.33 | $912.01 | $977.24 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $676.08 Median $776.25 Typical High $831.76 | Professional | AS · PA/NP assist | $676.08 | $776.25 | $831.76 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,905.46 Median $3,630.78 Typical High $3,630.78 | Professional | 52 · Reduced service | $1,905.46 | $3,630.78 | $3,630.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $776.25 Median $1,445.44 Typical High $1,445.44 | Professional | 53 · Discontinued | $776.25 | $1,445.44 | $1,445.44 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,884.03 Median $5,495.41 Typical High $5,495.41 | Professional | 54 · Surgery only | $2,884.03 | $5,495.41 | $5,495.41 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $575.44 Median $1,096.48 Typical High $1,096.48 | Professional | 55 · Aftercare only | $575.44 | $1,096.48 | $1,096.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $380.19 Median $724.44 Typical High $724.44 | Professional | 56 · Pre-op care only | $380.19 | $724.44 | $724.44 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,691.53 Median $5,128.61 Typical High $5,128.61 | Professional | 78 · Unplanned return to OR | $2,691.53 | $5,128.61 | $5,128.61 |
Where Idaho sits
The same service costs 10.8 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 $36,725WA $3,399
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.