How much rates vary
Facilitymedian $2,884 · 10th to 90th $724 to $12,023Professionalmedian $1,549 · 10th to 90th $724 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 $724.44 Median $724.44 Typical High $724.44 | Facility | None | $724.44 | $724.44 | $724.44 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | 54 · Surgery only | $549.54 | $549.54 | $549.54 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $512.86 | Facility | 78 · Unplanned return to OR | $512.86 | $512.86 | $512.86 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $794.33 | Professional | None | $724.44 | $724.44 | $794.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $575.44 | Professional | 54 · Surgery only | $549.54 | $549.54 | $575.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $537.03 |
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 $1,148.15 Median $1,548.82 Typical High $2,511.89 | Professional | None | $1,148.15 | $1,548.82 | $2,511.89 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,230.27 Typical High $1,995.26 | Professional | 54 · Surgery only | $912.01 | $1,230.27 | $1,995.26 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,318.26 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $977.24 | $1,318.26 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $1,862.09 Typical High $3,548.13 | Facility | None | $1,202.26 | $1,862.09 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,949.84 Typical High $3,090.30 | Professional | None | $1,148.15 | $1,949.84 | $3,090.30 |
Health Partners Setting Facility Modifier None Typical Low $1,071.52 Median $1,737.80 Typical High $3,019.95 | Facility | None | $1,071.52 | $1,737.80 | $3,019.95 |
Health Partners Setting Professional Modifier None Typical Low $1,023.29 Median $1,778.28 Typical High $2,884.03 | Professional | None | $1,023.29 | $1,778.28 | $2,884.03 |
Medica Setting Facility Modifier None Typical Low $1,288.25 Median $4,677.35 Typical High $10,715.19 | Facility | None | $1,288.25 | $4,677.35 | $10,715.19 |
Medica Setting Professional Modifier None Typical Low $812.83 Median $1,513.56 Typical High $6,456.54 | Professional | None | $812.83 | $1,513.56 | $6,456.54 |
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 $776.25 Median $1,348.96 Typical High $2,754.23 | Professional | None | $776.25 | $1,348.96 | $2,754.23 |
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 $363.08 Median $363.08 Typical High $363.08 | Facility | 52 · Reduced service | $363.08 | $363.08 | $363.08 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | 53 · Discontinued | $144.54 | $144.54 | $144.54 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | 55 · Aftercare only | $109.65 | $109.65 | $109.65 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | 56 · Pre-op care only | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $363.08 Median $363.08 Typical High $389.05 | Professional | 52 · Reduced service | $363.08 | $363.08 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $154.88 | Professional | 53 · Discontinued | $144.54 | $144.54 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $114.82 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $77.62 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $77.62 |
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 $1,737.80 Median $2,344.23 Typical High $3,801.89 | Professional | 50 · Both sides | $1,737.80 | $2,344.23 | $3,801.89 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $309.03 Typical High $501.19 | Professional | 55 · Aftercare only | $229.09 | $309.03 | $501.19 |
BCBS Minnesota Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $977.24 Typical High $1,548.82 | Professional | 62 · Two surgeons | $724.44 | $977.24 | $1,548.82 |
Where Minnesota sits
The same service costs 6.0 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 $14,230MT $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.