How much rates vary
Facilitymedian $5,495 · 10th to 90th $2,089 to $11,220Professionalmedian $4,898 · 10th to 90th $3,388 to $6,457
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 $2,818.38 Median $6,456.54 Typical High $6,456.54 | Professional | None | $2,818.38 | $6,456.54 | $6,456.54 |
BCBS Idaho Setting Facility Modifier None Typical Low $9,772.37 Median $10,471.29 Typical High $12,589.25 | Facility | None | $9,772.37 | $10,471.29 | $12,589.25 |
BCBS Idaho Setting Professional Modifier None Typical Low $4,466.84 Median $5,248.07 Typical High $5,623.41 | Professional | None | $4,466.84 | $5,248.07 | $5,623.41 |
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 $3,311.31 Median $3,630.78 Typical High $4,168.69 | Professional | None | $3,311.31 | $3,630.78 | $4,168.69 |
Moda Health Setting Facility Modifier None Typical Low $2,344.23 Median $5,495.41 Typical High $9,120.11 | Facility | None | $2,344.23 | $5,495.41 | $9,120.11 |
Moda Health Setting Professional Modifier None Typical Low $3,388.44 Median $6,309.57 Typical High $6,456.54 | Professional | None | $3,388.44 | $6,309.57 | $6,456.54 |
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 $3,981.07 Median $4,897.79 Typical High $4,897.79 | Facility | None | $3,981.07 | $4,897.79 | $4,897.79 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $6,606.93 | Professional | None | $4,897.79 | $4,897.79 | $6,606.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $5,011.87 Median $5,623.41 Typical High $6,309.57 | Professional | None | $5,011.87 | $5,623.41 | $6,309.57 |
Select Health Setting Facility Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,570.40 | Facility | None | $2,344.23 | $2,344.23 | $2,570.40 |
Select Health Setting Professional Modifier None Typical Low $2,344.23 Median $2,630.27 Typical High $4,073.80 | Professional | None | $2,344.23 | $2,630.27 | $4,073.80 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $5,495.41 Typical High $10,715.19 | Facility | None | $1,584.89 | $5,495.41 | $10,715.19 |
United Setting Professional Modifier None Typical Low $2,951.21 Median $4,073.80 Typical High $5,623.41 | Professional | None | $2,951.21 | $4,073.80 | $5,623.41 |
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 $1,698.24 Median $3,235.94 Typical High $3,235.94 | Professional | 52 · Reduced service | $1,698.24 | $3,235.94 | $3,235.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $676.08 Median $1,288.25 Typical High $1,288.25 | Professional | 53 · Discontinued | $676.08 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,570.40 Median $4,786.30 Typical High $4,786.30 | Professional | 54 · Surgery only | $2,570.40 | $4,786.30 | $4,786.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $512.86 Median $954.99 Typical High $954.99 | Professional | 55 · Aftercare only | $512.86 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $338.84 Median $645.65 Typical High $645.65 | Professional | 56 · Pre-op care only | $338.84 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,398.83 Median $4,466.84 Typical High $4,466.84 | Professional | 78 · Unplanned return to OR | $2,398.83 | $4,466.84 | $4,466.84 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $4,073.80 Median $4,570.88 Typical High $4,897.79 | Professional | 54 · Surgery only | $4,073.80 | $4,570.88 | $4,897.79 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $446.68 Median $501.19 Typical High $549.54 | Professional | 55 · Aftercare only | $446.68 | $501.19 | $549.54 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $2,818.38 Median $3,162.28 Typical High $3,388.44 | Professional | 62 · Two surgeons | $2,818.38 | $3,162.28 | $3,388.44 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $5,370.32 Median $6,025.60 Typical High $6,606.93 | Professional | 63 · Small infant | $5,370.32 | $6,025.60 | $6,606.93 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,162.28 Median $3,548.13 Typical High $3,801.89 | Professional | 78 · Unplanned return to OR | $3,162.28 | $3,548.13 | $3,801.89 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $724.44 Median $812.83 Typical High $870.96 | Professional | 80 · Assistant surgeon | $724.44 | $812.83 | $870.96 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $724.44 Median $812.83 Typical High $870.96 | Professional | 81 · Minimal assistant surgeon | $724.44 | $812.83 | $870.96 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $724.44 Median $812.83 Typical High $870.96 | Professional | 82 · Assistant surgeon, no resident | $724.44 | $812.83 | $870.96 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $616.60 Median $691.83 Typical High $741.31 | Professional | AS · PA/NP assist | $616.60 | $691.83 | $741.31 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,698.24 Median $3,235.94 Typical High $3,235.94 | Professional | 52 · Reduced service | $1,698.24 | $3,235.94 | $3,235.94 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $676.08 Median $1,288.25 Typical High $1,288.25 | Professional | 53 · Discontinued | $676.08 | $1,288.25 | $1,288.25 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,570.40 Median $4,786.30 Typical High $4,786.30 | Professional | 54 · Surgery only | $2,570.40 | $4,786.30 | $4,786.30 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $512.86 Median $954.99 Typical High $954.99 | Professional | 55 · Aftercare only | $512.86 | $954.99 | $954.99 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $338.84 Median $645.65 Typical High $645.65 | Professional | 56 · Pre-op care only | $338.84 | $645.65 | $645.65 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,398.83 Median $4,466.84 Typical High $4,466.84 | Professional | 78 · Unplanned return to OR | $2,398.83 | $4,466.84 | $4,466.84 |
Where Idaho sits
The same service costs 6.3 times more in Maine than in South Carolina. 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 $35,748SC $5,705
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.