How much rates vary
Facilitymedian $1,047 · 10th to 90th $759 to $2,344Professionalmedian $1,995 · 10th to 90th $1,047 to $2,692
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 $1,047.13 Median $1,047.13 Typical High $1,047.13 | Facility | None | $1,047.13 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,047.13 Typical High $1,584.89 | Professional | None | $954.99 | $1,047.13 | $1,584.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $794.33 Typical High $954.99 | Professional | 54 · Surgery only | $724.44 | $794.33 | $954.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $104.71 Typical High $128.82 | Professional | 56 · Pre-op care only | $95.50 | $104.71 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $741.31 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $676.08 | $741.31 | $891.25 |
BCBS Setting Professional Modifier None Typical Low $1,737.80 Median $2,238.72 Typical High $2,691.53 | Professional | None | $1,737.80 | $2,238.72 | $2,691.53 |
BCBS Setting Professional Modifier 22 · Increased work Typical Low $2,089.30 Median $2,691.53 Typical High $3,162.28 | Professional | 22 · Increased work | $2,089.30 | $2,691.53 | $3,162.28 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,584.89 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,230.27 | $1,584.89 | $1,862.09 |
BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $223.87 Typical High $269.15 | Professional | 56 · Pre-op care only | $173.78 | $223.87 | $269.15 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,698.24 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,698.24 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,995.26 | Facility | None | $1,737.80 | $1,737.80 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,949.84 Typical High $2,754.23 | Professional | None | $1,122.02 | $1,949.84 | $2,754.23 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,047.13 Typical High $2,398.83 | Facility | None | $758.58 | $1,047.13 | $2,398.83 |
Medica Setting Professional Modifier None Typical Low $851.14 Median $1,778.28 Typical High $7,762.47 | Professional | None | $851.14 | $1,778.28 | $7,762.47 |
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 $851.14 Median $1,479.11 Typical High $2,089.30 | Professional | None | $851.14 | $1,479.11 | $2,089.30 |
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 $478.63 Median $524.81 Typical High $630.96 | Professional | 52 · Reduced service | $478.63 | $524.81 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $208.93 Typical High $257.04 | Professional | 53 · Discontinued | $194.98 | $208.93 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $158.49 Typical High $190.55 | Professional | 55 · Aftercare only | $144.54 | $158.49 | $190.55 |
Where North Dakota sits
The same service costs 10.2 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 $17,229MD $1,684
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.