How much rates vary
Facilitymedian $1,096 · 10th to 90th $759 to $2,344Professionalmedian $2,089 · 10th to 90th $1,096 to $2,818
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 $1,096.48 Median $1,096.48 Typical High $1,096.48 | Facility | None | $1,096.48 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,096.48 Typical High $3,019.95 | Professional | None | $1,000.00 | $1,096.48 | $3,019.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $812.83 Typical High $977.24 | Professional | 54 · Surgery only | $758.58 | $812.83 | $977.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $109.65 Typical High $131.83 | Professional | 56 · Pre-op care only | $100.00 | $109.65 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $758.58 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $707.95 | $758.58 | $912.01 |
BCBS North Dakota Setting Professional Modifier None Typical Low $1,862.09 Median $2,398.83 Typical High $2,818.38 | Professional | None | $1,862.09 | $2,398.83 | $2,818.38 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $2,187.76 Median $2,884.03 Typical High $3,388.44 | Professional | 22 · Increased work | $2,187.76 | $2,884.03 | $3,388.44 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,659.59 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,288.25 | $1,659.59 | $1,949.84 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $239.88 Typical High $281.84 | Professional | 56 · Pre-op care only | $186.21 | $239.88 | $281.84 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,778.28 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,778.28 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,089.30 | Facility | None | $1,778.28 | $1,778.28 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,995.26 Typical High $2,818.38 | Professional | None | $1,174.90 | $1,995.26 | $2,818.38 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,096.48 Typical High $2,398.83 | Facility | None | $758.58 | $1,096.48 | $2,398.83 |
Medica Setting Professional Modifier None Typical Low $870.96 Median $1,862.09 Typical High $8,128.31 | Professional | None | $870.96 | $1,862.09 | $8,128.31 |
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 $891.25 Median $1,513.56 Typical High $2,137.96 | Professional | None | $891.25 | $1,513.56 | $2,137.96 |
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 $501.19 Median $537.03 Typical High $660.69 | Professional | 52 · Reduced service | $501.19 | $537.03 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $218.78 Typical High $263.03 | Professional | 53 · Discontinued | $199.53 | $218.78 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $162.18 Typical High $199.53 | Professional | 55 · Aftercare only | $151.36 | $162.18 | $199.53 |
Where North Dakota sits
The same service costs 10.0 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 $17,294MD $1,737
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.