How much rates vary
Facilitymedian $1,995 · 10th to 90th $661 to $6,918Professionalmedian $1,349 · 10th to 90th $661 to $2,512
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 $660.69 Median $660.69 Typical High $660.69 | Facility | None | $660.69 | $660.69 | $660.69 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | 54 · Surgery only | $489.78 | $489.78 | $489.78 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | 55 · Aftercare only | $97.72 | $97.72 | $97.72 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $457.09 | Facility | 78 · Unplanned return to OR | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $831.76 | Professional | None | $660.69 | $660.69 | $831.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $501.19 | Professional | 54 · Surgery only | $489.78 | $489.78 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $100.00 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $467.74 |
BCBS Minnesota Setting Facility Modifier None Typical Low $3,630.78 Median $6,165.95 Typical High $12,302.69 | Facility | None | $3,630.78 | $6,165.95 | $12,302.69 |
BCBS Minnesota Setting Professional Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $2,238.72 | Professional | None | $1,047.13 | $1,412.54 | $2,238.72 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $1,096.48 Typical High $1,778.28 | Professional | 54 · Surgery only | $831.76 | $1,096.48 | $1,778.28 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $281.84 Typical High $446.68 | Professional | 55 · Aftercare only | $208.93 | $281.84 | $446.68 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,174.90 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $870.96 | $1,174.90 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $1,659.59 Typical High $3,235.94 | Facility | None | $1,071.52 | $1,659.59 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,737.80 Typical High $2,754.23 | Professional | None | $1,023.29 | $1,737.80 | $2,754.23 |
Health Partners Setting Facility Modifier None Typical Low $954.99 Median $1,548.82 Typical High $2,691.53 | Facility | None | $954.99 | $1,548.82 | $2,691.53 |
Health Partners Setting Professional Modifier None Typical Low $912.01 Median $1,621.81 Typical High $2,630.27 | Professional | None | $912.01 | $1,621.81 | $2,630.27 |
Medica Setting Facility Modifier None Typical Low $1,148.15 Median $2,754.23 Typical High $7,762.47 | Facility | None | $1,148.15 | $2,754.23 | $7,762.47 |
Medica Setting Professional Modifier None Typical Low $724.44 Median $1,348.96 Typical High $5,888.44 | Professional | None | $724.44 | $1,348.96 | $5,888.44 |
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 $676.08 Median $1,174.90 Typical High $2,398.83 | Professional | None | $676.08 | $1,174.90 | $2,398.83 |
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 $331.13 Median $331.13 Typical High $331.13 | Facility | 52 · Reduced service | $331.13 | $331.13 | $331.13 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | 53 · Discontinued | $131.83 | $131.83 | $131.83 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | 56 · Pre-op care only | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $331.13 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $134.90 | Professional | 53 · Discontinued | $131.83 | $131.83 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $66.07 |
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 $1,548.82 Median $2,089.30 Typical High $3,388.44 | Professional | 50 · Both sides | $1,548.82 | $2,089.30 | $3,388.44 |
BCBS Minnesota Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $870.96 Typical High $1,412.54 | Professional | 62 · Two surgeons | $645.65 | $870.96 | $1,412.54 |
Where Minnesota sits
The same service costs 3.5 times more in Wisconsin than in Hawaii. 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 $7,283HI $2,091
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.