How much rates vary
Facilitymedian $1,318 · 10th to 90th $550 to $5,888Professionalmedian $2,692 · 10th to 90th $1,660 to $3,467
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 $1,445.44 Median $2,290.87 Typical High $3,467.37 | Professional | None | $1,445.44 | $2,290.87 | $3,467.37 |
BCBS Idaho Setting Facility Modifier None Typical Low $5,248.07 Median $5,623.41 Typical High $6,760.83 | Facility | None | $5,248.07 | $5,623.41 | $6,760.83 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,511.89 Median $2,951.21 Typical High $3,090.30 | Professional | None | $2,511.89 | $2,951.21 | $3,090.30 |
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 $1,819.70 Median $2,137.96 Typical High $2,454.71 | Professional | None | $1,819.70 | $2,137.96 | $2,454.71 |
Moda Health Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $5,495.41 | Facility | None | $1,318.26 | $3,467.37 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,862.09 Median $3,019.95 Typical High $3,467.37 | Professional | None | $1,862.09 | $3,019.95 | $3,467.37 |
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 $2,238.72 Median $2,754.23 Typical High $2,754.23 | Facility | None | $2,238.72 | $2,754.23 | $2,754.23 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $3,467.37 | Professional | None | $2,754.23 | $2,754.23 | $3,467.37 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,570.40 Median $3,090.30 Typical High $3,467.37 | Professional | None | $2,570.40 | $3,090.30 | $3,467.37 |
Select Health Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,445.44 | Facility | None | $1,318.26 | $1,318.26 | $1,445.44 |
Select Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,862.09 | Professional | None | $1,318.26 | $1,318.26 | $1,862.09 |
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 $1,479.11 Median $2,187.76 Typical High $3,235.94 | Professional | None | $1,479.11 | $2,187.76 | $3,235.94 |
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 $933.25 Median $1,737.80 Typical High $1,737.80 | Professional | 52 · Reduced service | $933.25 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $707.95 Typical High $707.95 | Professional | 53 · Discontinued | $371.54 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $2,630.27 Typical High $2,630.27 | Professional | 54 · Surgery only | $1,380.38 | $2,630.27 | $2,630.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $524.81 Typical High $524.81 | Professional | 55 · Aftercare only | $281.84 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $346.74 Typical High $346.74 | Professional | 56 · Pre-op care only | $186.21 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $2,454.71 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $1,288.25 | $2,454.71 | $2,454.71 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,238.72 Median $2,570.40 Typical High $2,754.23 | Professional | 54 · Surgery only | $2,238.72 | $2,570.40 | $2,754.23 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $281.84 Typical High $309.03 | Professional | 55 · Aftercare only | $245.47 | $281.84 | $309.03 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,548.82 Median $1,778.28 Typical High $1,905.46 | Professional | 62 · Two surgeons | $1,548.82 | $1,778.28 | $1,905.46 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $2,951.21 Median $3,388.44 Typical High $3,715.35 | Professional | 63 · Small infant | $2,951.21 | $3,388.44 | $3,715.35 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $1,995.26 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,737.80 | $1,995.26 | $2,137.96 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $398.11 Median $457.09 Typical High $489.78 | Professional | 80 · Assistant surgeon | $398.11 | $457.09 | $489.78 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $398.11 Median $457.09 Typical High $489.78 | Professional | 81 · Minimal assistant surgeon | $398.11 | $457.09 | $489.78 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $398.11 Median $457.09 Typical High $489.78 | Professional | 82 · Assistant surgeon, no resident | $398.11 | $457.09 | $489.78 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $338.84 Median $389.05 Typical High $416.87 | Professional | AS · PA/NP assist | $338.84 | $389.05 | $416.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $933.25 Median $1,737.80 Typical High $1,737.80 | Professional | 52 · Reduced service | $933.25 | $1,737.80 | $1,737.80 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $707.95 Typical High $707.95 | Professional | 53 · Discontinued | $371.54 | $707.95 | $707.95 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $2,630.27 Typical High $2,630.27 | Professional | 54 · Surgery only | $1,380.38 | $2,630.27 | $2,630.27 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $524.81 Typical High $524.81 | Professional | 55 · Aftercare only | $281.84 | $524.81 | $524.81 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $346.74 Typical High $346.74 | Professional | 56 · Pre-op care only | $186.21 | $346.74 | $346.74 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $2,454.71 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $1,288.25 | $2,454.71 | $2,454.71 |
Where Idaho sits
The same service costs 15.5 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 $34,449MD $2,222
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.