How much rates vary
Facilitymedian $2,344 · 10th to 90th $741 to $9,120Professionalmedian $1,549 · 10th to 90th $741 to $2,884
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 $741.31 Median $1,000.00 Typical High $2,344.23 | Facility | None | $741.31 | $1,000.00 | $2,344.23 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $562.34 | Facility | 54 · Surgery only | $562.34 | $562.34 | $562.34 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $524.81 | Facility | 78 · Unplanned return to OR | $524.81 | $524.81 | $524.81 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $977.24 | Professional | None | $741.31 | $741.31 | $977.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $562.34 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $524.81 |
BCBS Minnesota Setting Facility Modifier None Typical Low $4,073.80 Median $11,748.98 Typical High $26,915.35 | Facility | None | $4,073.80 | $11,748.98 | $26,915.35 |
BCBS Minnesota Setting Professional Modifier None Typical Low $1,202.26 Median $1,584.89 Typical High $2,570.40 | Professional | None | $1,202.26 | $1,584.89 | $2,570.40 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,258.93 Typical High $2,041.74 | Professional | 54 · Surgery only | $954.99 | $1,258.93 | $2,041.74 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,318.26 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,318.26 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $1,905.46 Typical High $3,630.78 | Facility | None | $1,230.27 | $1,905.46 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,995.26 Typical High $3,162.28 | Professional | None | $1,174.90 | $1,995.26 | $3,162.28 |
Health Partners Setting Facility Modifier None Typical Low $1,096.48 Median $1,778.28 Typical High $3,090.30 | Facility | None | $1,096.48 | $1,778.28 | $3,090.30 |
Health Partners Setting Professional Modifier None Typical Low $1,047.13 Median $1,819.70 Typical High $2,951.21 | Professional | None | $1,047.13 | $1,819.70 | $2,951.21 |
Medica Setting Facility Modifier None Typical Low $1,258.93 Median $3,388.44 Typical High $9,772.37 | Facility | None | $1,258.93 | $3,388.44 | $9,772.37 |
Medica Setting Professional Modifier None Typical Low $812.83 Median $1,513.56 Typical High $12,022.64 | Professional | None | $812.83 | $1,513.56 | $12,022.64 |
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 $758.58 Median $1,318.26 Typical High $2,691.53 | Professional | None | $758.58 | $1,318.26 | $2,691.53 |
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 $371.54 Median $371.54 Typical High $371.54 | Facility | 52 · Reduced service | $371.54 | $371.54 | $371.54 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $147.91 | Facility | 53 · Discontinued | $147.91 | $147.91 | $147.91 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | 55 · Aftercare only | $112.20 | $112.20 | $112.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $74.13 | Facility | 56 · Pre-op care only | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $371.54 Median $371.54 Typical High $380.19 | Professional | 52 · Reduced service | $371.54 | $371.54 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $151.36 | Professional | 53 · Discontinued | $147.91 | $147.91 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $75.86 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $75.86 |
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 $1,778.28 Median $2,398.83 Typical High $3,801.89 | Professional | 50 · Both sides | $1,778.28 | $2,398.83 | $3,801.89 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $323.59 Typical High $512.86 | Professional | 55 · Aftercare only | $239.88 | $323.59 | $512.86 |
BCBS Minnesota Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $1,000.00 Typical High $1,584.89 | Professional | 62 · Two surgeons | $741.31 | $1,000.00 | $1,584.89 |
Where Minnesota sits
The same service costs 5.7 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 $13,613MT $2,377
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.