How much rates vary
Facilitymedian $1,514 · 10th to 90th $550 to $7,079Professionalmedian $3,236 · 10th to 90th $2,239 to $4,266
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 $1,862.09 Median $4,265.80 Typical High $4,265.80 | Professional | None | $1,862.09 | $4,265.80 | $4,265.80 |
BCBS Idaho Setting Facility Modifier None Typical Low $6,456.54 Median $6,918.31 Typical High $8,317.64 | Facility | None | $6,456.54 | $6,918.31 | $8,317.64 |
BCBS Idaho Setting Professional Modifier None Typical Low $2,951.21 Median $3,467.37 Typical High $3,630.78 | Professional | None | $2,951.21 | $3,467.37 | $3,630.78 |
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 $2,187.76 Median $2,454.71 Typical High $2,754.23 | Professional | None | $2,187.76 | $2,454.71 | $2,754.23 |
Moda Health Setting Facility Modifier None Typical Low $1,513.56 Median $4,265.80 Typical High $6,025.60 | Facility | None | $1,513.56 | $4,265.80 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $2,238.72 Median $4,168.69 Typical High $4,265.80 | Professional | None | $2,238.72 | $4,168.69 | $4,265.80 |
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 $2,630.27 Median $3,235.94 Typical High $3,235.94 | Facility | None | $2,630.27 | $3,235.94 | $3,235.94 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $4,365.16 | Professional | None | $3,235.94 | $3,235.94 | $4,365.16 |
Regence BlueShield 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 |
Select Health Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,659.59 | Facility | None | $1,513.56 | $1,513.56 | $1,659.59 |
Select Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,778.28 Typical High $2,691.53 | Professional | None | $1,513.56 | $1,778.28 | $2,691.53 |
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 $1,949.84 Median $2,691.53 Typical High $3,715.35 | Professional | None | $1,949.84 | $2,691.53 | $3,715.35 |
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 $1,122.02 Median $2,137.96 Typical High $2,137.96 | Professional | 52 · Reduced service | $1,122.02 | $2,137.96 | $2,137.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $851.14 Typical High $851.14 | Professional | 53 · Discontinued | $446.68 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $3,162.28 Typical High $3,162.28 | Professional | 54 · Surgery only | $1,698.24 | $3,162.28 | $3,162.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $630.96 Typical High $630.96 | Professional | 55 · Aftercare only | $338.84 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $426.58 Typical High $426.58 | Professional | 56 · Pre-op care only | $223.87 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $2,951.21 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $1,584.89 | $2,951.21 | $2,951.21 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $2,691.53 Median $2,951.21 Typical High $3,235.94 | Professional | 54 · Surgery only | $2,691.53 | $2,951.21 | $3,235.94 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $331.13 Typical High $363.08 | Professional | 55 · Aftercare only | $295.12 | $331.13 | $363.08 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $1,862.09 Median $2,089.30 Typical High $2,238.72 | Professional | 62 · Two surgeons | $1,862.09 | $2,089.30 | $2,238.72 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $3,548.13 Median $3,981.07 Typical High $4,365.16 | Professional | 63 · Small infant | $3,548.13 | $3,981.07 | $4,365.16 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,089.30 Median $2,344.23 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $2,089.30 | $2,344.23 | $2,511.89 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $478.63 Median $524.81 Typical High $575.44 | Professional | 80 · Assistant surgeon | $478.63 | $524.81 | $575.44 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $478.63 Median $524.81 Typical High $575.44 | Professional | 81 · Minimal assistant surgeon | $478.63 | $524.81 | $575.44 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $478.63 Median $524.81 Typical High $575.44 | Professional | 82 · Assistant surgeon, no resident | $478.63 | $524.81 | $575.44 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $407.38 Median $446.68 Typical High $489.78 | Professional | AS · PA/NP assist | $407.38 | $446.68 | $489.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,122.02 Median $2,137.96 Typical High $2,137.96 | Professional | 52 · Reduced service | $1,122.02 | $2,137.96 | $2,137.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $851.14 Typical High $851.14 | Professional | 53 · Discontinued | $446.68 | $851.14 | $851.14 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $3,162.28 Typical High $3,162.28 | Professional | 54 · Surgery only | $1,698.24 | $3,162.28 | $3,162.28 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $630.96 Typical High $630.96 | Professional | 55 · Aftercare only | $338.84 | $630.96 | $630.96 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $426.58 Typical High $426.58 | Professional | 56 · Pre-op care only | $223.87 | $426.58 | $426.58 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $2,951.21 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $1,584.89 | $2,951.21 | $2,951.21 |
Where Idaho sits
The same service costs 14.4 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 $34,547MD $2,395
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.