How much rates vary
Facilitymedian $2,188 · 10th to 90th $813 to $7,762Professionalmedian $1,698 · 10th to 90th $813 to $3,090
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 $812.83 | Facility | None | $812.83 | $812.83 | $812.83 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $602.56 | Facility | 54 · Surgery only | $602.56 | $602.56 | $602.56 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $562.34 | Facility | 78 · Unplanned return to OR | $562.34 | $562.34 | $562.34 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $851.14 | Professional | None | $812.83 | $812.83 | $851.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $616.60 | Professional | 54 · Surgery only | $602.56 | $602.56 | $616.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $575.44 |
BCBS Minnesota Setting Facility Modifier None Typical Low $4,265.80 Median $6,456.54 Typical High $12,302.69 | Facility | None | $4,265.80 | $6,456.54 | $12,302.69 |
BCBS Minnesota Setting Professional Modifier None Typical Low $1,288.25 Median $1,737.80 Typical High $2,818.38 | Professional | None | $1,288.25 | $1,737.80 | $2,818.38 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,412.54 Typical High $2,238.72 | Professional | 54 · Surgery only | $1,023.29 | $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 $2,344.23 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,479.11 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $2,041.74 Typical High $3,890.45 | Facility | None | $1,318.26 | $2,041.74 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $2,137.96 Typical High $3,388.44 | Professional | None | $1,258.93 | $2,137.96 | $3,388.44 |
Health Partners Setting Facility Modifier None Typical Low $1,174.90 Median $1,905.46 Typical High $3,311.31 | Facility | None | $1,174.90 | $1,905.46 | $3,311.31 |
Health Partners Setting Professional Modifier None Typical Low $1,122.02 Median $1,995.26 Typical High $3,162.28 | Professional | None | $1,122.02 | $1,995.26 | $3,162.28 |
Medica Setting Facility Modifier None Typical Low $1,412.54 Median $2,754.23 Typical High $7,762.47 | Facility | None | $1,412.54 | $2,754.23 | $7,762.47 |
Medica Setting Professional Modifier None Typical Low $870.96 Median $1,584.89 Typical High $6,025.60 | Professional | None | $870.96 | $1,584.89 | $6,025.60 |
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 $812.83 Median $1,445.44 Typical High $2,951.21 | Professional | None | $812.83 | $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 $120.23 Median $120.23 Typical High $120.23 | Facility | 55 · Aftercare only | $120.23 | $120.23 | $120.23 |
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 $165.96 | Professional | 53 · Discontinued | $162.18 | $162.18 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $123.03 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $83.18 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $83.18 |
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 $1,949.84 Median $2,630.27 Typical High $4,265.80 | Professional | 50 · Both sides | $1,949.84 | $2,630.27 | $4,265.80 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $346.74 Typical High $562.34 | Professional | 55 · Aftercare only | $257.04 | $346.74 | $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 3.1 times more in Wisconsin 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
WI $8,115MD $2,591
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.