How much rates vary
Facilitymedian $1,738 · 10th to 90th $759 to $2,570Professionalmedian $3,236 · 10th to 90th $1,738 to $4,467
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $1,737.80 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,737.80 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,737.80 Typical High $4,677.35 | Professional | None | $1,584.89 | $1,737.80 | $4,677.35 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,288.25 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,174.90 | $1,288.25 | $1,584.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $173.78 Typical High $208.93 | Professional | 56 · Pre-op care only | $158.49 | $173.78 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,202.26 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,202.26 | $1,479.11 |
BCBS North Dakota Setting Professional Modifier None Typical Low $2,884.03 Median $3,715.35 Typical High $4,365.16 | Professional | None | $2,884.03 | $3,715.35 | $4,365.16 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $3,467.37 Median $4,466.84 Typical High $5,248.07 | Professional | 22 · Increased work | $3,467.37 | $4,466.84 | $5,248.07 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $2,630.27 Typical High $3,090.30 | Professional | 54 · Surgery only | $1,995.26 | $2,630.27 | $3,090.30 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $371.54 Typical High $436.52 | Professional | 56 · Pre-op care only | $288.40 | $371.54 | $436.52 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,137.96 Median $2,818.38 Typical High $3,311.31 | Professional | 78 · Unplanned return to OR | $2,137.96 | $2,818.38 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $3,311.31 | Facility | None | $2,818.38 | $2,818.38 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $3,162.28 Typical High $4,466.84 | Professional | None | $1,819.70 | $3,162.28 | $4,466.84 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,737.80 Typical High $2,951.21 | Facility | None | $758.58 | $1,737.80 | $2,951.21 |
Medica Setting Professional Modifier None Typical Low $1,380.38 Median $2,951.21 Typical High $12,882.50 | Professional | None | $1,380.38 | $2,951.21 | $12,882.50 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,288.25 Typical High $2,511.89 | Facility | None | $758.58 | $1,288.25 | $2,511.89 |
United Setting Professional Modifier None Typical Low $1,412.54 Median $2,398.83 Typical High $3,467.37 | Professional | None | $1,412.54 | $2,398.83 | $3,467.37 |
3 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 $794.33 Median $870.96 Typical High $1,047.13 | Professional | 52 · Reduced service | $794.33 | $870.96 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $346.74 Typical High $416.87 | Professional | 53 · Discontinued | $316.23 | $346.74 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $257.04 Typical High $316.23 | Professional | 55 · Aftercare only | $239.88 | $257.04 | $316.23 |
Where North Dakota sits
The same service costs 7.6 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 $18,140MD $2,382
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.