How much rates vary
Facilitymedian $1,950 · 10th to 90th $759 to $2,692Professionalmedian $3,715 · 10th to 90th $1,950 to $5,012
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 $1,949.84 Median $1,949.84 Typical High $1,949.84 | Facility | None | $1,949.84 | $1,949.84 | $1,949.84 |
Aetna Setting Professional Modifier None Typical Low $1,778.28 Median $1,949.84 Typical High $3,981.07 | Professional | None | $1,778.28 | $1,949.84 | $3,981.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,479.11 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,348.96 | $1,479.11 | $1,778.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $194.98 Typical High $234.42 | Professional | 56 · Pre-op care only | $177.83 | $194.98 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,380.38 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,380.38 | $1,659.59 |
BCBS North Dakota Setting Professional Modifier None Typical Low $3,235.94 Median $4,168.69 Typical High $5,011.87 | Professional | None | $3,235.94 | $4,168.69 | $5,011.87 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $3,890.45 Median $5,011.87 Typical High $5,888.44 | Professional | 22 · Increased work | $3,890.45 | $5,011.87 | $5,888.44 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $2,290.87 Median $2,951.21 Typical High $3,467.37 | Professional | 54 · Surgery only | $2,290.87 | $2,951.21 | $3,467.37 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $323.59 Median $416.87 Typical High $501.19 | Professional | 56 · Pre-op care only | $323.59 | $416.87 | $501.19 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,454.71 Median $3,162.28 Typical High $3,715.35 | Professional | 78 · Unplanned return to OR | $2,454.71 | $3,162.28 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,715.35 | Facility | None | $3,162.28 | $3,162.28 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $2,089.30 Median $3,548.13 Typical High $5,011.87 | Professional | None | $2,089.30 | $3,548.13 | $5,011.87 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,949.84 Typical High $3,311.31 | Facility | None | $758.58 | $1,949.84 | $3,311.31 |
Medica Setting Professional Modifier None Typical Low $1,584.89 Median $3,311.31 Typical High $14,454.40 | Professional | None | $1,584.89 | $3,311.31 | $14,454.40 |
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 $1,584.89 Median $2,691.53 Typical High $3,890.45 | Professional | None | $1,584.89 | $2,691.53 | $3,890.45 |
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 $891.25 Median $977.24 Typical High $1,174.90 | Professional | 52 · Reduced service | $891.25 | $977.24 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $389.05 Typical High $467.74 | Professional | 53 · Discontinued | $354.81 | $389.05 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $295.12 Typical High $354.81 | Professional | 55 · Aftercare only | $269.15 | $295.12 | $354.81 |
Where North Dakota sits
The same service costs 6.9 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 $18,419MD $2,652
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.