How much rates vary
Facilitymedian $1,950 · 10th to 90th $550 to $9,772Professionalmedian $4,074 · 10th to 90th $2,754 to $6,026
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 $2,884.03 Median $6,025.60 Typical High $6,025.60 | Professional | None | $2,884.03 | $6,025.60 | $6,025.60 |
BCBS Idaho Setting Facility Modifier None Typical Low $8,912.51 Median $9,549.93 Typical High $11,481.54 | Facility | None | $8,912.51 | $9,549.93 | $11,481.54 |
BCBS Idaho Setting Professional Modifier None Typical Low $3,801.89 Median $4,466.84 Typical High $4,897.79 | Professional | None | $3,801.89 | $4,466.84 | $4,897.79 |
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 $3,090.30 Median $3,548.13 Typical High $4,168.69 | Professional | None | $3,090.30 | $3,548.13 | $4,168.69 |
Moda Health Setting Facility Modifier None Typical Low $1,949.84 Median $5,495.41 Typical High $8,511.38 | Facility | None | $1,949.84 | $5,495.41 | $8,511.38 |
Moda Health Setting Professional Modifier None Typical Low $3,090.30 Median $4,466.84 Typical High $6,025.60 | Professional | None | $3,090.30 | $4,466.84 | $6,025.60 |
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 $3,311.31 Median $4,073.80 Typical High $4,073.80 | Facility | None | $3,311.31 | $4,073.80 | $4,073.80 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $5,128.61 | Professional | None | $4,073.80 | $4,073.80 | $5,128.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $4,073.80 Median $4,897.79 Typical High $5,888.44 | Professional | None | $4,073.80 | $4,897.79 | $5,888.44 |
Select Health Setting Facility Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,041.74 | Facility | None | $1,949.84 | $1,949.84 | $2,041.74 |
Select Health Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $3,090.30 | Professional | None | $1,949.84 | $1,949.84 | $3,090.30 |
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 $2,398.83 Median $3,630.78 Typical High $5,128.61 | Professional | None | $2,398.83 | $3,630.78 | $5,128.61 |
22 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 $1,412.54 Median $3,019.95 Typical High $3,019.95 | Professional | 52 · Reduced service | $1,412.54 | $3,019.95 | $3,019.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $1,202.26 Typical High $1,202.26 | Professional | 53 · Discontinued | $575.44 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,137.96 Median $4,466.84 Typical High $4,466.84 | Professional | 54 · Surgery only | $2,137.96 | $4,466.84 | $4,466.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $426.58 Median $891.25 Typical High $891.25 | Professional | 55 · Aftercare only | $426.58 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $281.84 Median $602.56 Typical High $602.56 | Professional | 56 · Pre-op care only | $281.84 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,995.26 Median $4,168.69 Typical High $4,168.69 | Professional | 78 · Unplanned return to OR | $1,995.26 | $4,168.69 | $4,168.69 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $5,495.41 Median $6,456.54 Typical High $6,918.31 | Professional | 50 · Both sides | $5,495.41 | $6,456.54 | $6,918.31 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $3,311.31 Median $3,890.45 Typical High $4,168.69 | Professional | 54 · Surgery only | $3,311.31 | $3,890.45 | $4,168.69 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $436.52 Typical High $467.74 | Professional | 55 · Aftercare only | $363.08 | $436.52 | $467.74 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $2,290.87 Median $2,691.53 Typical High $2,884.03 | Professional | 62 · Two surgeons | $2,290.87 | $2,691.53 | $2,884.03 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $4,365.16 Median $5,248.07 Typical High $5,495.41 | Professional | 63 · Small infant | $4,365.16 | $5,248.07 | $5,495.41 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,570.40 Median $3,019.95 Typical High $3,235.94 | Professional | 78 · Unplanned return to OR | $2,570.40 | $3,019.95 | $3,235.94 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $588.84 Median $691.83 Typical High $741.31 | Professional | 80 · Assistant surgeon | $588.84 | $691.83 | $741.31 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $588.84 Median $691.83 Typical High $741.31 | Professional | 81 · Minimal assistant surgeon | $588.84 | $691.83 | $741.31 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $588.84 Median $691.83 Typical High $741.31 | Professional | 82 · Assistant surgeon, no resident | $588.84 | $691.83 | $741.31 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $501.19 Median $588.84 Typical High $630.96 | Professional | AS · PA/NP assist | $501.19 | $588.84 | $630.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,513.56 Median $3,019.95 Typical High $3,019.95 | Professional | 52 · Reduced service | $1,513.56 | $3,019.95 | $3,019.95 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $616.60 Median $1,202.26 Typical High $1,202.26 | Professional | 53 · Discontinued | $616.60 | $1,202.26 | $1,202.26 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,290.87 Median $4,466.84 Typical High $4,466.84 | Professional | 54 · Surgery only | $2,290.87 | $4,466.84 | $4,466.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $457.09 Median $891.25 Typical High $891.25 | Professional | 55 · Aftercare only | $457.09 | $891.25 | $891.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $309.03 Median $602.56 Typical High $602.56 | Professional | 56 · Pre-op care only | $309.03 | $602.56 | $602.56 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,137.96 Median $4,168.69 Typical High $4,168.69 | Professional | 78 · Unplanned return to OR | $2,137.96 | $4,168.69 | $4,168.69 |
Where Idaho sits
The same service costs 13.0 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 $35,671WA $2,745
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.