How much rates vary
Facilitymedian $2,138 · 10th to 90th $617 to $6,761Professionalmedian $1,318 · 10th to 90th $617 to $2,455
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 $616.60 Median $616.60 Typical High $616.60 | Facility | None | $616.60 | $616.60 | $616.60 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | 54 · Surgery only | $467.74 | $467.74 | $467.74 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | 55 · Aftercare only | $93.33 | $93.33 | $93.33 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $436.52 | Facility | 78 · Unplanned return to OR | $436.52 | $436.52 | $436.52 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $691.83 | Professional | None | $616.60 | $616.60 | $691.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $501.19 | Professional | 54 · Surgery only | $467.74 | $467.74 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $100.00 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $467.74 |
BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $3,981.07 Typical High $7,244.36 | Facility | None | $2,137.96 | $3,981.07 | $7,244.36 |
BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $2,187.76 | Professional | None | $1,023.29 | $1,380.38 | $2,187.76 |
BCBS 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 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 Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,148.15 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $851.14 | $1,148.15 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $1,584.89 Typical High $3,019.95 | Facility | None | $1,023.29 | $1,584.89 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,659.59 Typical High $2,630.27 | Professional | None | $977.24 | $1,659.59 | $2,630.27 |
Health Partners Setting Facility Modifier None Typical Low $912.01 Median $1,445.44 Typical High $2,570.40 | Facility | None | $912.01 | $1,445.44 | $2,570.40 |
Health Partners Setting Professional Modifier None Typical Low $870.96 Median $1,513.56 Typical High $2,454.71 | Professional | None | $870.96 | $1,513.56 | $2,454.71 |
Medica Setting Facility Modifier None Typical Low $1,047.13 Median $4,168.69 Typical High $9,332.54 | Facility | None | $1,047.13 | $4,168.69 | $9,332.54 |
Medica Setting Professional Modifier None Typical Low $707.95 Median $1,288.25 Typical High $4,786.30 | Professional | None | $707.95 | $1,288.25 | $4,786.30 |
United Setting Facility Modifier None Typical Low $3,235.94 Median $5,370.32 Typical High $10,964.78 | Facility | None | $3,235.94 | $5,370.32 | $10,964.78 |
United Setting Professional Modifier None Typical Low $660.69 Median $1,174.90 Typical High $2,398.83 | Professional | None | $660.69 | $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 $309.03 Median $309.03 Typical High $309.03 | Facility | 52 · Reduced service | $309.03 | $309.03 | $309.03 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | 53 · Discontinued | $123.03 | $123.03 | $123.03 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | 56 · Pre-op care only | $61.66 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $309.03 Median $309.03 Typical High $338.84 | Professional | 52 · Reduced service | $309.03 | $309.03 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $134.90 | Professional | 53 · Discontinued | $123.03 | $123.03 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $67.61 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $67.61 |
BCBS Setting Facility Modifier 50 · Both sides Typical Low $3,162.28 Median $5,754.40 Typical High $10,964.78 | Facility | 50 · Both sides | $3,162.28 | $5,754.40 | $10,964.78 |
BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,548.82 Median $2,041.74 Typical High $3,311.31 | Professional | 50 · Both sides | $1,548.82 | $2,041.74 | $3,311.31 |
BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $870.96 Typical High $1,348.96 | Professional | 62 · Two surgeons | $645.65 | $870.96 | $1,348.96 |
Where Minnesota sits
The same service costs 7.8 times more in Oklahoma than in Texas. 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
OK $11,491TX $1,472
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.