How much rates vary
Facilitymedian $1,230 · 10th to 90th $759 to $2,399Professionalmedian $2,399 · 10th to 90th $1,230 to $3,236
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 $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,230.27 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,230.27 Typical High $3,311.31 | Professional | None | $1,148.15 | $1,230.27 | $3,311.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $933.25 Typical High $1,047.13 | Professional | 54 · Surgery only | $851.14 | $933.25 | $1,047.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $123.03 Typical High $141.25 | Professional | 56 · Pre-op care only | $114.82 | $123.03 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $870.96 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $794.33 | $870.96 | $977.24 |
BCBS Setting Professional Modifier None Typical Low $2,137.96 Median $2,754.23 Typical High $3,235.94 | Professional | None | $2,137.96 | $2,754.23 | $3,235.94 |
BCBS Setting Professional Modifier 22 · Increased work Typical Low $2,570.40 Median $3,311.31 Typical High $3,890.45 | Professional | 22 · Increased work | $2,570.40 | $3,311.31 | $3,890.45 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,905.46 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,479.11 | $1,905.46 | $2,290.87 |
BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $275.42 Typical High $323.59 | Professional | 56 · Pre-op care only | $213.80 | $275.42 | $323.59 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $2,041.74 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $1,584.89 | $2,041.74 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,398.83 | Facility | None | $2,041.74 | $2,041.74 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $2,290.87 Typical High $3,235.94 | Professional | None | $1,318.26 | $2,290.87 | $3,235.94 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,230.27 Typical High $2,398.83 | Facility | None | $758.58 | $1,230.27 | $2,398.83 |
Medica Setting Professional Modifier None Typical Low $1,000.00 Median $2,089.30 Typical High $9,120.11 | Professional | None | $1,000.00 | $2,089.30 | $9,120.11 |
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 $1,023.29 Median $1,659.59 Typical High $2,398.83 | Professional | None | $1,023.29 | $1,659.59 | $2,398.83 |
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 $575.44 Median $616.60 Typical High $707.95 | Professional | 52 · Reduced service | $575.44 | $616.60 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $251.19 Typical High $281.84 | Professional | 53 · Discontinued | $229.09 | $251.19 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $186.21 Typical High $208.93 | Professional | 55 · Aftercare only | $173.78 | $186.21 | $208.93 |
Where North Dakota sits
The same service costs 8.1 times more in Maine than in Texas. 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 $13,962TX $1,718
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.