How much rates vary
Facilitymedian $1,549 · 10th to 90th $759 to $2,570Professionalmedian $2,951 · 10th to 90th $1,514 to $3,981
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 $1,548.82 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,548.82 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,548.82 Typical High $2,398.83 | Professional | None | $1,412.54 | $1,548.82 | $2,398.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,174.90 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,071.52 | $1,174.90 | $1,412.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $154.88 Typical High $190.55 | Professional | 56 · Pre-op care only | $144.54 | $154.88 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,096.48 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,096.48 | $1,318.26 |
BCBS North Dakota Setting Professional Modifier None Typical Low $2,630.27 Median $3,388.44 Typical High $3,981.07 | Professional | None | $2,630.27 | $3,388.44 | $3,981.07 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $2,344.23 Typical High $2,818.38 | Professional | 54 · Surgery only | $1,819.70 | $2,344.23 | $2,818.38 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $263.03 Median $338.84 Typical High $398.11 | Professional | 56 · Pre-op care only | $263.03 | $338.84 | $398.11 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,949.84 Median $2,511.89 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $1,949.84 | $2,511.89 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,951.21 | Facility | None | $2,570.40 | $2,570.40 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $2,884.03 Typical High $4,073.80 | Professional | None | $1,659.59 | $2,884.03 | $4,073.80 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,548.82 Typical High $2,630.27 | Facility | None | $758.58 | $1,548.82 | $2,630.27 |
Medica Setting Professional Modifier None Typical Low $1,258.93 Median $2,630.27 Typical High $11,481.54 | Professional | None | $1,258.93 | $2,630.27 | $11,481.54 |
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 $1,258.93 Median $2,187.76 Typical High $3,090.30 | Professional | None | $1,258.93 | $2,187.76 | $3,090.30 |
4 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 $724.44 Median $776.25 Typical High $933.25 | Professional | 52 · Reduced service | $724.44 | $776.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $309.03 Typical High $380.19 | Professional | 53 · Discontinued | $288.40 | $309.03 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $234.42 Typical High $281.84 | Professional | 55 · Aftercare only | $213.80 | $234.42 | $281.84 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $3,162.28 Median $4,073.80 Typical High $4,786.30 | Professional | 22 · Increased work | $3,162.28 | $4,073.80 | $4,786.30 |
Where North Dakota sits
The same service costs 8.1 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 $2,222
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.