How much rates vary
Facilitymedian $3,236 · 10th to 90th $977 to $11,220Professionalmedian $2,089 · 10th to 90th $977 to $3,802
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 $977.24 Median $977.24 Typical High $977.24 | Facility | None | $977.24 | $977.24 | $977.24 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $741.31 | Facility | 54 · Surgery only | $741.31 | $741.31 | $741.31 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $691.83 | Facility | 78 · Unplanned return to OR | $691.83 | $691.83 | $691.83 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,122.02 | Professional | None | $977.24 | $977.24 | $1,122.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $776.25 | Professional | 54 · Surgery only | $741.31 | $741.31 | $776.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $724.44 |
BCBS Setting Facility Modifier None Typical Low $2,630.27 Median $9,549.93 Typical High $26,302.68 | Facility | None | $2,630.27 | $9,549.93 | $26,302.68 |
BCBS Setting Professional Modifier None Typical Low $1,548.82 Median $2,137.96 Typical High $3,388.44 | Professional | None | $1,548.82 | $2,137.96 | $3,388.44 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,698.24 Typical High $2,691.53 | Professional | 54 · Surgery only | $1,258.93 | $1,698.24 | $2,691.53 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,778.28 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,778.28 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $2,511.89 Typical High $4,786.30 | Facility | None | $1,621.81 | $2,511.89 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $2,630.27 Typical High $4,168.69 | Professional | None | $1,548.82 | $2,630.27 | $4,168.69 |
Health Partners Setting Facility Modifier None Typical Low $1,445.44 Median $2,344.23 Typical High $4,073.80 | Facility | None | $1,445.44 | $2,344.23 | $4,073.80 |
Health Partners Setting Professional Modifier None Typical Low $1,380.38 Median $2,454.71 Typical High $3,890.45 | Professional | None | $1,380.38 | $2,454.71 | $3,890.45 |
Medica Setting Facility Modifier None Typical Low $1,737.80 Median $4,677.35 Typical High $10,715.19 | Facility | None | $1,737.80 | $4,677.35 | $10,715.19 |
Medica Setting Professional Modifier None Typical Low $1,122.02 Median $2,041.74 Typical High $7,413.10 | Professional | None | $1,122.02 | $2,041.74 | $7,413.10 |
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 $1,047.13 Median $1,819.70 Typical High $3,715.35 | Professional | None | $1,047.13 | $1,819.70 | $3,715.35 |
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 $489.78 Median $489.78 Typical High $489.78 | Facility | 52 · Reduced service | $489.78 | $489.78 | $489.78 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $199.53 | Facility | 53 · Discontinued | $199.53 | $199.53 | $199.53 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $147.91 | Facility | 55 · Aftercare only | $147.91 | $147.91 | $147.91 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | 56 · Pre-op care only | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $489.78 Median $489.78 Typical High $524.81 | Professional | 52 · Reduced service | $489.78 | $489.78 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $208.93 | Professional | 53 · Discontinued | $199.53 | $199.53 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $154.88 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $104.71 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $104.71 |
BCBS Setting Facility Modifier 50 · Both sides Typical Low $10,232.93 Median $25,703.96 Typical High $41,686.94 | Facility | 50 · Both sides | $10,232.93 | $25,703.96 | $41,686.94 |
BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,344.23 Median $3,162.28 Typical High $5,128.61 | Professional | 50 · Both sides | $2,344.23 | $3,162.28 | $5,128.61 |
BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $426.58 Typical High $676.08 | Professional | 55 · Aftercare only | $316.23 | $426.58 | $676.08 |
BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $977.24 Median $1,288.25 Typical High $2,041.74 | Professional | 62 · Two surgeons | $977.24 | $1,288.25 | $2,041.74 |
Where Minnesota sits
The same service costs 5.3 times more in Oklahoma 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
OK $14,385HI $2,704
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.