How much rates vary
Facilitymedian $3,162 · 10th to 90th $813 to $10,233Professionalmedian $1,698 · 10th to 90th $813 to $3,162
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 $812.83 Median $812.83 Typical High $10,000.00 | Facility | None | $812.83 | $812.83 | $10,000.00 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $616.60 | Facility | 54 · Surgery only | $616.60 | $616.60 | $616.60 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $575.44 | Facility | 78 · Unplanned return to OR | $575.44 | $575.44 | $575.44 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $870.96 | Professional | None | $812.83 | $812.83 | $870.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $630.96 | Professional | 54 · Surgery only | $616.60 | $616.60 | $630.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $588.84 |
BCBS Minnesota Setting Facility Modifier None Typical Low $4,466.84 Median $11,748.98 Typical High $26,915.35 | Facility | None | $4,466.84 | $11,748.98 | $26,915.35 |
BCBS Minnesota Setting Professional Modifier None Typical Low $1,288.25 Median $1,778.28 Typical High $2,884.03 | Professional | None | $1,288.25 | $1,778.28 | $2,884.03 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,412.54 Typical High $2,238.72 | Professional | 54 · Surgery only | $1,047.13 | $1,412.54 | $2,238.72 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,479.11 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,479.11 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $2,089.30 Typical High $3,981.07 | Facility | None | $1,348.96 | $2,089.30 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $2,187.76 Typical High $3,388.44 | Professional | None | $1,288.25 | $2,187.76 | $3,388.44 |
Health Partners Setting Facility Modifier None Typical Low $1,202.26 Median $1,905.46 Typical High $3,311.31 | Facility | None | $1,202.26 | $1,905.46 | $3,311.31 |
Health Partners Setting Professional Modifier None Typical Low $1,148.15 Median $1,995.26 Typical High $3,235.94 | Professional | None | $1,148.15 | $1,995.26 | $3,235.94 |
Medica Setting Facility Modifier None Typical Low $1,412.54 Median $3,801.89 Typical High $10,000.00 | Facility | None | $1,412.54 | $3,801.89 | $10,000.00 |
Medica Setting Professional Modifier None Typical Low $891.25 Median $1,698.24 Typical High $6,025.60 | Professional | None | $891.25 | $1,698.24 | $6,025.60 |
United Setting Facility Modifier None Typical Low $2,818.38 Median $4,466.84 Typical High $11,220.18 | Facility | None | $2,818.38 | $4,466.84 | $11,220.18 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,445.44 Typical High $2,951.21 | Professional | None | $831.76 | $1,445.44 | $2,951.21 |
12 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 $407.38 Median $407.38 Typical High $407.38 | Facility | 52 · Reduced service | $407.38 | $407.38 | $407.38 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | 53 · Discontinued | $162.18 | $162.18 | $162.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | 55 · Aftercare only | $123.03 | $123.03 | $123.03 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | 56 · Pre-op care only | $81.28 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $407.38 Median $407.38 Typical High $416.87 | Professional | 52 · Reduced service | $407.38 | $407.38 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $169.82 | Professional | 53 · Discontinued | $162.18 | $162.18 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $125.89 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $85.11 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $85.11 |
BCBS Minnesota Setting Facility Modifier 50 · Both sides Typical Low $14,125.38 Median $26,302.68 Typical High $47,863.01 | Facility | 50 · Both sides | $14,125.38 | $26,302.68 | $47,863.01 |
BCBS Minnesota Setting Professional Modifier 50 · Both sides Typical Low $1,949.84 Median $2,630.27 Typical High $4,365.16 | Professional | 50 · Both sides | $1,949.84 | $2,630.27 | $4,365.16 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $354.81 Typical High $562.34 | Professional | 55 · Aftercare only | $257.04 | $354.81 | $562.34 |
BCBS Minnesota Setting Professional Modifier 62 · Two surgeons Typical Low $812.83 Median $1,096.48 Typical High $1,737.80 | Professional | 62 · Two surgeons | $812.83 | $1,096.48 | $1,737.80 |
Where Minnesota sits
The same service costs 5.9 times more in Colorado than in West Virginia. 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
CO $14,031WV $2,390
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.