How much rates vary
Facilitymedian $1,995 · 10th to 90th $603 to $7,079Professionalmedian $1,259 · 10th to 90th $603 to $2,344
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 $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $457.09 | Facility | 54 · Surgery only | $457.09 | $457.09 | $457.09 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $426.58 | Facility | 78 · Unplanned return to OR | $426.58 | $426.58 | $426.58 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $630.96 | Professional | None | $602.56 | $602.56 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $467.74 | Professional | 54 · Surgery only | $457.09 | $457.09 | $467.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $426.58 | $426.58 | $436.52 |
BCBS Minnesota Setting Facility Modifier None Typical Low $3,467.37 Median $6,165.95 Typical High $12,302.69 | Facility | None | $3,467.37 | $6,165.95 | $12,302.69 |
BCBS Minnesota Setting Professional Modifier None Typical Low $912.01 Median $1,258.93 Typical High $2,041.74 | Professional | None | $912.01 | $1,258.93 | $2,041.74 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $1,000.00 Typical High $1,621.81 | Professional | 54 · Surgery only | $741.31 | $1,000.00 | $1,621.81 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $1,047.13 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $776.25 | $1,047.13 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $1,548.82 Typical High $2,951.21 | Facility | None | $1,000.00 | $1,548.82 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,621.81 Typical High $2,511.89 | Professional | None | $954.99 | $1,621.81 | $2,511.89 |
Health Partners Setting Facility Modifier None Typical Low $891.25 Median $1,412.54 Typical High $2,454.71 | Facility | None | $891.25 | $1,412.54 | $2,454.71 |
Health Partners Setting Professional Modifier None Typical Low $851.14 Median $1,479.11 Typical High $2,398.83 | Professional | None | $851.14 | $1,479.11 | $2,398.83 |
Medica Setting Facility Modifier None Typical Low $1,047.13 Median $2,754.23 Typical High $7,762.47 | Facility | None | $1,047.13 | $2,754.23 | $7,762.47 |
Medica Setting Professional Modifier None Typical Low $691.83 Median $1,258.93 Typical High $5,370.32 | Professional | None | $691.83 | $1,258.93 | $5,370.32 |
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 $616.60 Median $1,148.15 Typical High $2,238.72 | Professional | None | $616.60 | $1,148.15 | $2,238.72 |
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 $302.00 Median $302.00 Typical High $302.00 | Facility | 52 · Reduced service | $302.00 | $302.00 | $302.00 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | 53 · Discontinued | $120.23 | $120.23 | $120.23 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | 55 · Aftercare only | $91.20 | $91.20 | $91.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | 56 · Pre-op care only | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $302.00 Median $302.00 Typical High $316.23 | Professional | 52 · Reduced service | $302.00 | $302.00 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $125.89 | Professional | 53 · Discontinued | $120.23 | $120.23 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $93.33 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $60.26 Typical High $63.10 | Professional | 56 · Pre-op care only | $60.26 | $60.26 | $63.10 |
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 $1,380.38 Median $1,862.09 Typical High $3,019.95 | Professional | 50 · Both sides | $1,380.38 | $1,862.09 | $3,019.95 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $251.19 Typical High $407.38 | Professional | 55 · Aftercare only | $186.21 | $251.19 | $407.38 |
BCBS Minnesota Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $776.25 Typical High $1,230.27 | Professional | 62 · Two surgeons | $575.44 | $776.25 | $1,230.27 |
Where Minnesota sits
The same service costs 4.2 times more in Wisconsin 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
WI $7,788MT $1,867
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.