How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,122 to $10,471Professionalmedian $5,012 · 10th to 90th $2,818 to $9,333
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 $2,398.83 Median $2,398.83 Typical High $2,398.83 | Facility | None | $2,398.83 | $2,398.83 | $2,398.83 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Facility | 54 · Surgery only | $1,778.28 | $1,778.28 | $1,778.28 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $354.81 Median $354.81 Typical High $354.81 | Facility | 55 · Aftercare only | $354.81 | $354.81 | $354.81 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Facility | 78 · Unplanned return to OR | $1,659.59 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,818.38 | Professional | None | $2,398.83 | $2,398.83 | $2,818.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,778.28 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,778.28 | $1,778.28 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $354.81 Typical High $426.58 | Professional | 55 · Aftercare only | $354.81 | $354.81 | $426.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,659.59 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,659.59 | $1,995.26 |
BCBS Minnesota Setting Facility Modifier None Typical Low $3,801.89 Median $10,471.29 Typical High $21,379.62 | Facility | None | $3,801.89 | $10,471.29 | $21,379.62 |
BCBS Minnesota Setting Professional Modifier None Typical Low $3,801.89 Median $5,011.87 Typical High $8,128.31 | Professional | None | $3,801.89 | $5,011.87 | $8,128.31 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $3,019.95 Median $3,981.07 Typical High $6,456.54 | Professional | 54 · Surgery only | $3,019.95 | $3,981.07 | $6,456.54 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $758.58 Median $1,000.00 Typical High $1,621.81 | Professional | 55 · Aftercare only | $758.58 | $1,000.00 | $1,621.81 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,162.28 Median $4,168.69 Typical High $6,918.31 | Professional | 78 · Unplanned return to OR | $3,162.28 | $4,168.69 | $6,918.31 |
Cigna Setting Facility Modifier None Typical Low $3,630.78 Median $5,623.41 Typical High $10,715.19 | Facility | None | $3,630.78 | $5,623.41 | $10,715.19 |
Cigna Setting Professional Modifier None Typical Low $4,073.80 Median $6,456.54 Typical High $10,000.00 | Professional | None | $4,073.80 | $6,456.54 | $10,000.00 |
Health Partners Setting Facility Modifier None Typical Low $3,162.28 Median $5,128.61 Typical High $8,912.51 | Facility | None | $3,162.28 | $5,128.61 | $8,912.51 |
Health Partners Setting Professional Modifier None Typical Low $3,630.78 Median $5,754.40 Typical High $8,912.51 | Professional | None | $3,630.78 | $5,754.40 | $8,912.51 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,445.44 Typical High $4,168.69 | Facility | None | $758.58 | $1,445.44 | $4,168.69 |
Medica Setting Professional Modifier None Typical Low $2,754.23 Median $5,248.07 Typical High $16,982.44 | Professional | None | $2,754.23 | $5,248.07 | $16,982.44 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,513.56 Typical High $3,630.78 | Facility | None | $758.58 | $1,513.56 | $3,630.78 |
United Setting Professional Modifier None Typical Low $2,511.89 Median $4,677.35 Typical High $9,772.37 | Professional | None | $2,511.89 | $4,677.35 | $9,772.37 |
7 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 $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | 52 · Reduced service | $1,174.90 | $1,174.90 | $1,174.90 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $478.63 Median $478.63 Typical High $478.63 | Facility | 53 · Discontinued | $478.63 | $478.63 | $478.63 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | 56 · Pre-op care only | $239.88 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1,174.90 Median $1,174.90 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,174.90 | $1,174.90 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $478.63 Typical High $575.44 | Professional | 53 · Discontinued | $478.63 | $478.63 | $575.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $239.88 Typical High $281.84 | Professional | 56 · Pre-op care only | $239.88 | $239.88 | $281.84 |
BCBS Minnesota Setting Professional Modifier 62 · Two surgeons Typical Low $2,398.83 Median $3,162.28 Typical High $5,128.61 | Professional | 62 · Two surgeons | $2,398.83 | $3,162.28 | $5,128.61 |
Where Minnesota sits
The same service costs 7.4 times more in Alaska than in Washington. 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
AK $20,770WA $2,820
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.