How much rates vary
Facilitymedian $871 · 10th to 90th $550 to $4,169Professionalmedian $1,778 · 10th to 90th $1,175 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 $1,202.26 Median $2,290.87 Typical High $2,290.87 | Professional | None | $1,202.26 | $2,290.87 | $2,290.87 |
BCBS Idaho Setting Facility Modifier None Typical Low $3,548.13 Median $3,801.89 Typical High $4,570.88 | Facility | None | $3,548.13 | $3,801.89 | $4,570.88 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,659.59 Median $1,949.84 Typical High $1,995.26 | Professional | None | $1,659.59 | $1,949.84 | $1,995.26 |
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 $1,174.90 Median $1,380.38 Typical High $1,584.89 | Professional | None | $1,174.90 | $1,380.38 | $1,584.89 |
Moda Health Setting Facility Modifier None Typical Low $851.14 Median $2,290.87 Typical High $5,495.41 | Facility | None | $851.14 | $2,290.87 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,995.26 Typical High $2,290.87 | Professional | None | $1,202.26 | $1,995.26 | $2,290.87 |
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 $1,445.44 Median $1,778.28 Typical High $1,778.28 | Facility | None | $1,445.44 | $1,778.28 | $1,778.28 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,238.72 | Professional | None | $1,778.28 | $1,778.28 | $2,238.72 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,737.80 Median $1,995.26 Typical High $2,238.72 | Professional | None | $1,737.80 | $1,995.26 | $2,238.72 |
Select Health Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $933.25 | Facility | None | $851.14 | $851.14 | $933.25 |
Select Health Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,202.26 | Professional | None | $851.14 | $851.14 | $1,202.26 |
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 $977.24 Median $1,479.11 Typical High $2,089.30 | Professional | None | $977.24 | $1,479.11 | $2,089.30 |
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 $602.56 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $602.56 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $239.88 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,698.24 Typical High $1,698.24 | Professional | 54 · Surgery only | $912.01 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $338.84 Typical High $338.84 | Professional | 55 · Aftercare only | $181.97 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $120.23 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,584.89 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $851.14 | $1,584.89 | $1,584.89 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,659.59 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,445.44 | $1,659.59 | $1,778.28 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $181.97 Typical High $199.53 | Professional | 55 · Aftercare only | $158.49 | $181.97 | $199.53 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,000.00 Median $1,148.15 Typical High $1,258.93 | Professional | 62 · Two surgeons | $1,000.00 | $1,148.15 | $1,258.93 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,905.46 Median $2,187.76 Typical High $2,398.83 | Professional | 63 · Small infant | $1,905.46 | $2,187.76 | $2,398.83 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,288.25 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,288.25 | $1,412.54 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $295.12 Typical High $316.23 | Professional | 80 · Assistant surgeon | $257.04 | $295.12 | $316.23 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $257.04 Median $295.12 Typical High $316.23 | Professional | 81 · Minimal assistant surgeon | $257.04 | $295.12 | $316.23 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $257.04 Median $295.12 Typical High $316.23 | Professional | 82 · Assistant surgeon, no resident | $257.04 | $295.12 | $316.23 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $218.78 Median $251.19 Typical High $269.15 | Professional | AS · PA/NP assist | $218.78 | $251.19 | $269.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $602.56 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $602.56 | $1,148.15 | $1,148.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $239.88 | $457.09 | $457.09 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,698.24 Typical High $1,698.24 | Professional | 54 · Surgery only | $912.01 | $1,698.24 | $1,698.24 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $338.84 Typical High $338.84 | Professional | 55 · Aftercare only | $181.97 | $338.84 | $338.84 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $120.23 | $229.09 | $229.09 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,584.89 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $851.14 | $1,584.89 | $1,584.89 |
Where Idaho sits
The same service costs 9.8 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 $16,204MD $1,659
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.