How much rates vary
Facilitymedian $2,818 · 10th to 90th $1,349 to $4,571Professionalmedian $2,570 · 10th to 90th $1,349 to $3,467
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 $1,348.96 Median $1,348.96 Typical High $1,348.96 | Facility | None | $1,348.96 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,348.96 Typical High $3,235.94 | Professional | None | $1,230.27 | $1,348.96 | $3,235.94 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,023.29 Typical High $1,230.27 | Professional | 54 · Surgery only | $933.25 | $1,023.29 | $1,230.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $134.90 Typical High $165.96 | Professional | 56 · Pre-op care only | $125.89 | $134.90 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $954.99 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $870.96 | $954.99 | $1,148.15 |
BCBS North Dakota Setting Facility Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Facility | None | $2,511.89 | $2,511.89 | $2,511.89 |
BCBS North Dakota Setting Professional Modifier None Typical Low $2,290.87 Median $2,951.21 Typical High $3,467.37 | Professional | None | $2,290.87 | $2,951.21 | $3,467.37 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $2,041.74 Typical High $2,398.83 | Professional | 54 · Surgery only | $1,584.89 | $2,041.74 | $2,398.83 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $295.12 Typical High $346.74 | Professional | 56 · Pre-op care only | $229.09 | $295.12 | $346.74 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $2,187.76 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $1,698.24 | $2,187.76 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,570.40 | Facility | None | $2,238.72 | $2,238.72 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $2,511.89 Typical High $3,548.13 | Professional | None | $1,445.44 | $2,511.89 | $3,548.13 |
Medica Setting Facility Modifier None Typical Low $1,348.96 Median $2,884.03 Typical High $4,570.88 | Facility | None | $1,348.96 | $2,884.03 | $4,570.88 |
Medica Setting Professional Modifier None Typical Low $1,148.15 Median $2,290.87 Typical High $10,000.00 | Professional | None | $1,148.15 | $2,290.87 | $10,000.00 |
United Setting Facility Modifier None Typical Low $2,818.38 Median $4,168.69 Typical High $4,677.35 | Facility | None | $2,818.38 | $4,168.69 | $4,677.35 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,905.46 Typical High $2,691.53 | Professional | None | $1,148.15 | $1,905.46 | $2,691.53 |
4 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 $630.96 Median $676.08 Typical High $831.76 | Professional | 52 · Reduced service | $630.96 | $676.08 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $269.15 Typical High $331.13 | Professional | 53 · Discontinued | $251.19 | $269.15 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $204.17 Typical High $245.47 | Professional | 55 · Aftercare only | $186.21 | $204.17 | $245.47 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $2,691.53 Median $3,548.13 Typical High $4,168.69 | Professional | 22 · Increased work | $2,691.53 | $3,548.13 | $4,168.69 |
Where North Dakota sits
The same service costs 8.5 times more in Maine than in Delaware. 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 $28,081DE $3,299
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.