How much rates vary
Facilitymedian $1,950 · 10th to 90th $550 to $8,913Professionalmedian $4,169 · 10th to 90th $2,818 to $5,370
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 $2,344.23 Median $5,370.32 Typical High $5,370.32 | Professional | None | $2,344.23 | $5,370.32 | $5,370.32 |
BCBS Idaho Setting Facility Modifier None Typical Low $8,128.31 Median $8,709.64 Typical High $10,471.29 | Facility | None | $8,128.31 | $8,709.64 | $10,471.29 |
BCBS Idaho Setting Professional Modifier None Typical Low $3,801.89 Median $4,466.84 Typical High $4,677.35 | Professional | None | $3,801.89 | $4,466.84 | $4,677.35 |
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 $2,818.38 Median $3,090.30 Typical High $3,548.13 | Professional | None | $2,818.38 | $3,090.30 | $3,548.13 |
Moda Health Setting Facility Modifier None Typical Low $1,949.84 Median $5,370.32 Typical High $7,762.47 | Facility | None | $1,949.84 | $5,370.32 | $7,762.47 |
Moda Health Setting Professional Modifier None Typical Low $2,884.03 Median $5,370.32 Typical High $5,370.32 | Professional | None | $2,884.03 | $5,370.32 | $5,370.32 |
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 $5,495.41 | Professional | None | $4,073.80 | $4,073.80 | $5,495.41 |
Regence BlueShield Setting Professional Modifier None Typical Low $4,168.69 Median $4,677.35 Typical High $5,370.32 | Professional | None | $4,168.69 | $4,677.35 | $5,370.32 |
Select Health Setting Facility Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,137.96 | Facility | None | $1,949.84 | $1,949.84 | $2,137.96 |
Select Health Setting Professional Modifier None Typical Low $1,949.84 Median $2,238.72 Typical High $3,388.44 | Professional | None | $1,949.84 | $2,238.72 | $3,388.44 |
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 $2,454.71 Median $3,388.44 Typical High $4,677.35 | Professional | None | $2,454.71 | $3,388.44 | $4,677.35 |
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 $1,412.54 Median $2,691.53 Typical High $2,691.53 | Professional | 52 · Reduced service | $1,412.54 | $2,691.53 | $2,691.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $1,071.52 Typical High $1,071.52 | Professional | 53 · Discontinued | $575.44 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,137.96 Median $4,073.80 Typical High $4,073.80 | Professional | 54 · Surgery only | $2,137.96 | $4,073.80 | $4,073.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $426.58 Median $812.83 Typical High $812.83 | Professional | 55 · Aftercare only | $426.58 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $537.03 Typical High $537.03 | Professional | 56 · Pre-op care only | $288.40 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,995.26 Median $3,801.89 Typical High $3,801.89 | Professional | 78 · Unplanned return to OR | $1,995.26 | $3,801.89 | $3,801.89 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $3,388.44 Median $3,801.89 Typical High $4,073.80 | Professional | 54 · Surgery only | $3,388.44 | $3,801.89 | $4,073.80 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $426.58 Typical High $457.09 | Professional | 55 · Aftercare only | $380.19 | $426.58 | $457.09 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $2,344.23 Median $2,630.27 Typical High $2,884.03 | Professional | 62 · Two surgeons | $2,344.23 | $2,630.27 | $2,884.03 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $4,570.88 Median $5,128.61 Typical High $5,495.41 | Professional | 63 · Small infant | $4,570.88 | $5,128.61 | $5,495.41 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,630.27 Median $2,951.21 Typical High $3,235.94 | Professional | 78 · Unplanned return to OR | $2,630.27 | $2,951.21 | $3,235.94 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $602.56 Median $676.08 Typical High $724.44 | Professional | 80 · Assistant surgeon | $602.56 | $676.08 | $724.44 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $602.56 Median $676.08 Typical High $724.44 | Professional | 81 · Minimal assistant surgeon | $602.56 | $676.08 | $724.44 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $602.56 Median $676.08 Typical High $724.44 | Professional | 82 · Assistant surgeon, no resident | $602.56 | $676.08 | $724.44 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $512.86 Median $575.44 Typical High $616.60 | Professional | AS · PA/NP assist | $512.86 | $575.44 | $616.60 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,412.54 Median $2,691.53 Typical High $2,691.53 | Professional | 52 · Reduced service | $1,412.54 | $2,691.53 | $2,691.53 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $1,071.52 Typical High $1,071.52 | Professional | 53 · Discontinued | $575.44 | $1,071.52 | $1,071.52 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,137.96 Median $4,073.80 Typical High $4,073.80 | Professional | 54 · Surgery only | $2,137.96 | $4,073.80 | $4,073.80 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $426.58 Median $812.83 Typical High $812.83 | Professional | 55 · Aftercare only | $426.58 | $812.83 | $812.83 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $537.03 Typical High $537.03 | Professional | 56 · Pre-op care only | $288.40 | $537.03 | $537.03 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,995.26 Median $3,801.89 Typical High $3,801.89 | Professional | 78 · Unplanned return to OR | $1,995.26 | $3,801.89 | $3,801.89 |
Where Idaho sits
The same service costs 12.4 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 $35,178WA $2,843
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.