How much rates vary
Facilitymedian $1,995 · 10th to 90th $562 to $6,918Professionalmedian $1,175 · 10th to 90th $562 to $2,138
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $562.34 Median $562.34 Typical High $562.34 | Facility | None | $562.34 | $562.34 | $562.34 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $416.87 | Facility | 54 · Surgery only | $416.87 | $416.87 | $416.87 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | 55 · Aftercare only | $83.18 | $83.18 | $83.18 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | 78 · Unplanned return to OR | $389.05 | $389.05 | $389.05 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $691.83 | Professional | None | $562.34 | $562.34 | $691.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $436.52 | Professional | 54 · Surgery only | $416.87 | $416.87 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $87.10 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $389.05 | $389.05 | $407.38 |
BCBS Minnesota Setting Facility Modifier None Typical Low $3,090.30 Median $6,165.95 Typical High $12,302.69 | Facility | None | $3,090.30 | $6,165.95 | $12,302.69 |
BCBS Minnesota Setting Professional Modifier None Typical Low $912.01 Median $1,258.93 Typical High $1,949.84 | Professional | None | $912.01 | $1,258.93 | $1,949.84 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,000.00 Typical High $1,548.82 | Professional | 54 · Surgery only | $724.44 | $1,000.00 | $1,548.82 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $251.19 Typical High $389.05 | Professional | 55 · Aftercare only | $186.21 | $251.19 | $389.05 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $1,047.13 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $758.58 | $1,047.13 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $1,412.54 Typical High $2,691.53 | Facility | None | $912.01 | $1,412.54 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,479.11 Typical High $2,344.23 | Professional | None | $870.96 | $1,479.11 | $2,344.23 |
Health Partners Setting Facility Modifier None Typical Low $812.83 Median $1,318.26 Typical High $2,290.87 | Facility | None | $812.83 | $1,318.26 | $2,290.87 |
Health Partners Setting Professional Modifier None Typical Low $776.25 Median $1,380.38 Typical High $2,187.76 | Professional | None | $776.25 | $1,380.38 | $2,187.76 |
Medica Setting Facility Modifier None Typical Low $977.24 Median $2,754.23 Typical High $7,762.47 | Facility | None | $977.24 | $2,754.23 | $7,762.47 |
Medica Setting Professional Modifier None Typical Low $602.56 Median $1,122.02 Typical High $4,168.69 | Professional | None | $602.56 | $1,122.02 | $4,168.69 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $3,090.30 Typical High $8,511.38 | Facility | None | $1,995.26 | $3,090.30 | $8,511.38 |
United Setting Professional Modifier None Typical Low $575.44 Median $1,000.00 Typical High $2,041.74 | Professional | None | $575.44 | $1,000.00 | $2,041.74 |
9 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 Facility Modifier 52 · Reduced service Typical Low $281.84 Median $281.84 Typical High $281.84 | Facility | 52 · Reduced service | $281.84 | $281.84 | $281.84 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | 53 · Discontinued | $112.20 | $112.20 | $112.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | 56 · Pre-op care only | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $281.84 Median $281.84 Typical High $295.12 | Professional | 52 · Reduced service | $281.84 | $281.84 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $117.49 | Professional | 53 · Discontinued | $112.20 | $112.20 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $58.88 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $58.88 |
BCBS Minnesota Setting Facility Modifier 50 · Both sides Typical Low $6,456.54 Median $12,022.64 Typical High $21,379.62 | Facility | 50 · Both sides | $6,456.54 | $12,022.64 | $21,379.62 |
BCBS Minnesota Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $1,862.09 Typical High $2,951.21 | Professional | 50 · Both sides | $1,380.38 | $1,862.09 | $2,951.21 |
BCBS Minnesota Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $776.25 Typical High $1,202.26 | Professional | 62 · Two surgeons | $575.44 | $776.25 | $1,202.26 |
Where Minnesota sits
The same service costs 4.1 times more in Wisconsin than in Montana. 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
WI $7,505MT $1,845
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.