How much rates vary
Facilitymedian $1,514 · 10th to 90th $759 to $2,512Professionalmedian $2,884 · 10th to 90th $1,514 to $3,890
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 $1,513.56 Median $1,513.56 Typical High $1,513.56 | Facility | None | $1,513.56 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,513.56 Typical High $3,090.30 | Professional | None | $1,380.38 | $1,513.56 | $3,090.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,148.15 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,047.13 | $1,148.15 | $1,380.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $151.36 Typical High $186.21 | Professional | 56 · Pre-op care only | $138.04 | $151.36 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,071.52 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $977.24 | $1,071.52 | $1,288.25 |
BCBS North Dakota Setting Professional Modifier None Typical Low $2,570.40 Median $3,311.31 Typical High $3,890.45 | Professional | None | $2,570.40 | $3,311.31 | $3,890.45 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $3,090.30 Median $3,981.07 Typical High $4,677.35 | Professional | 22 · Increased work | $3,090.30 | $3,981.07 | $4,677.35 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $2,290.87 Typical High $2,691.53 | Professional | 54 · Surgery only | $1,778.28 | $2,290.87 | $2,691.53 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $331.13 Typical High $389.05 | Professional | 56 · Pre-op care only | $257.04 | $331.13 | $389.05 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,905.46 Median $2,454.71 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $1,905.46 | $2,454.71 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,884.03 | Facility | None | $2,511.89 | $2,511.89 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $2,818.38 Typical High $3,981.07 | Professional | None | $1,621.81 | $2,818.38 | $3,981.07 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,513.56 Typical High $2,570.40 | Facility | None | $758.58 | $1,513.56 | $2,570.40 |
Medica Setting Professional Modifier None Typical Low $1,230.27 Median $2,570.40 Typical High $11,220.18 | Professional | None | $1,230.27 | $2,570.40 | $11,220.18 |
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 $1,230.27 Median $2,137.96 Typical High $3,019.95 | Professional | None | $1,230.27 | $2,137.96 | $3,019.95 |
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 $691.83 Median $758.58 Typical High $933.25 | Professional | 52 · Reduced service | $691.83 | $758.58 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $302.00 Typical High $371.54 | Professional | 53 · Discontinued | $281.84 | $302.00 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $229.09 Typical High $275.42 | Professional | 55 · Aftercare only | $208.93 | $229.09 | $275.42 |
Where North Dakota sits
The same service costs 8.2 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 $17,891MD $2,184
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.