How much rates vary
Facilitymedian $2,512 · 10th to 90th $631 to $11,749Professionalmedian $1,318 · 10th to 90th $631 to $2,399
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 $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $478.63 | Facility | 54 · Surgery only | $478.63 | $478.63 | $478.63 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $446.68 | Facility | 78 · Unplanned return to OR | $446.68 | $446.68 | $446.68 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $630.96 Typical High $812.83 | Professional | None | $616.60 | $630.96 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $446.68 |
BCBS Minnesota Setting Facility Modifier None Typical Low $3,467.37 Median $11,748.98 Typical High $26,915.35 | Facility | None | $3,467.37 | $11,748.98 | $26,915.35 |
BCBS Minnesota Setting Professional Modifier None Typical Low $1,000.00 Median $1,380.38 Typical High $2,187.76 | Professional | None | $1,000.00 | $1,380.38 | $2,187.76 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,096.48 Typical High $1,737.80 | Professional | 54 · Surgery only | $812.83 | $1,096.48 | $1,737.80 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,148.15 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $851.14 | $1,148.15 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $1,047.13 Median $1,621.81 Typical High $3,090.30 | Facility | None | $1,047.13 | $1,621.81 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,698.24 Typical High $2,630.27 | Professional | None | $1,000.00 | $1,698.24 | $2,630.27 |
Health Partners Setting Facility Modifier None Typical Low $933.25 Median $1,479.11 Typical High $2,570.40 | Facility | None | $933.25 | $1,479.11 | $2,570.40 |
Health Partners Setting Professional Modifier None Typical Low $891.25 Median $1,548.82 Typical High $2,511.89 | Professional | None | $891.25 | $1,548.82 | $2,511.89 |
Medica Setting Facility Modifier None Typical Low $1,096.48 Median $4,897.79 Typical High $11,220.18 | Facility | None | $1,096.48 | $4,897.79 | $11,220.18 |
Medica Setting Professional Modifier None Typical Low $676.08 Median $1,258.93 Typical High $4,677.35 | Professional | None | $676.08 | $1,258.93 | $4,677.35 |
United Setting Facility Modifier None Typical Low $3,235.94 Median $5,370.32 Typical High $12,882.50 | Facility | None | $3,235.94 | $5,370.32 | $12,882.50 |
United Setting Professional Modifier None Typical Low $630.96 Median $1,096.48 Typical High $2,238.72 | Professional | None | $630.96 | $1,096.48 | $2,238.72 |
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 $316.23 Median $316.23 Typical High $316.23 | Facility | 52 · Reduced service | $316.23 | $316.23 | $316.23 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | 53 · Discontinued | $125.89 | $125.89 | $125.89 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | 55 · Aftercare only | $95.50 | $95.50 | $95.50 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | 56 · Pre-op care only | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $316.23 Median $316.23 Typical High $323.59 | Professional | 52 · Reduced service | $316.23 | $316.23 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $128.82 | Professional | 53 · Discontinued | $125.89 | $125.89 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $64.57 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $64.57 |
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 $1,513.56 Median $2,041.74 Typical High $3,311.31 | Professional | 50 · Both sides | $1,513.56 | $2,041.74 | $3,311.31 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $275.42 Typical High $436.52 | Professional | 55 · Aftercare only | $204.17 | $275.42 | $436.52 |
BCBS Minnesota Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $851.14 Typical High $1,380.38 | Professional | 62 · Two surgeons | $630.96 | $851.14 | $1,380.38 |
Where Minnesota sits
The same service costs 6.8 times more in Colorado 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
CO $13,753MT $2,023
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.