How much rates vary
Facilitymedian $7,413 · 10th to 90th $1,122 to $20,417Professionalmedian $10,233 · 10th to 90th $5,623 to $18,621
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 $4,786.30 Median $4,786.30 Typical High $4,786.30 | Facility | None | $4,786.30 | $4,786.30 | $4,786.30 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Facility | 54 · Surgery only | $3,630.78 | $3,630.78 | $3,630.78 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $724.44 Median $724.44 Typical High $724.44 | Facility | 55 · Aftercare only | $724.44 | $724.44 | $724.44 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Facility | 78 · Unplanned return to OR | $3,388.44 | $3,388.44 | $3,388.44 |
Aetna Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $5,754.40 | Professional | None | $4,786.30 | $4,786.30 | $5,754.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,630.78 Median $3,630.78 Typical High $4,365.16 | Professional | 54 · Surgery only | $3,630.78 | $3,630.78 | $4,365.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $724.44 Median $724.44 Typical High $870.96 | Professional | 55 · Aftercare only | $724.44 | $724.44 | $870.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,388.44 Median $3,388.44 Typical High $4,073.80 | Professional | 78 · Unplanned return to OR | $3,388.44 | $3,388.44 | $4,073.80 |
BCBS Minnesota Setting Facility Modifier None Typical Low $9,549.93 Median $20,417.38 Typical High $50,118.72 | Facility | None | $9,549.93 | $20,417.38 | $50,118.72 |
BCBS Minnesota Setting Professional Modifier None Typical Low $7,585.78 Median $10,232.93 Typical High $16,595.87 | Professional | None | $7,585.78 | $10,232.93 | $16,595.87 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $6,165.95 Median $8,128.31 Typical High $13,182.57 | Professional | 54 · Surgery only | $6,165.95 | $8,128.31 | $13,182.57 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $1,513.56 Median $2,041.74 Typical High $3,311.31 | Professional | 55 · Aftercare only | $1,513.56 | $2,041.74 | $3,311.31 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $6,456.54 Median $8,511.38 Typical High $14,125.38 | Professional | 78 · Unplanned return to OR | $6,456.54 | $8,511.38 | $14,125.38 |
Cigna Setting Facility Modifier None Typical Low $7,244.36 Median $11,220.18 Typical High $21,379.62 | Facility | None | $7,244.36 | $11,220.18 | $21,379.62 |
Cigna Setting Professional Modifier None Typical Low $8,511.38 Median $12,882.50 Typical High $20,417.38 | Professional | None | $8,511.38 | $12,882.50 | $20,417.38 |
Health Partners Setting Facility Modifier None Typical Low $6,456.54 Median $10,471.29 Typical High $18,197.01 | Facility | None | $6,456.54 | $10,471.29 | $18,197.01 |
Health Partners Setting Professional Modifier None Typical Low $7,244.36 Median $11,748.98 Typical High $17,782.79 | Professional | None | $7,244.36 | $11,748.98 | $17,782.79 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,445.44 Typical High $8,128.31 | Facility | None | $758.58 | $1,445.44 | $8,128.31 |
Medica Setting Professional Modifier None Typical Low $5,623.41 Median $10,715.19 Typical High $154,881.66 | Professional | None | $5,623.41 | $10,715.19 | $154,881.66 |
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 $5,011.87 Median $9,549.93 Typical High $19,952.62 | Professional | None | $5,011.87 | $9,549.93 | $19,952.62 |
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 $2,398.83 Median $2,398.83 Typical High $2,398.83 | Facility | 52 · Reduced service | $2,398.83 | $2,398.83 | $2,398.83 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $954.99 Median $954.99 Typical High $954.99 | Facility | 53 · Discontinued | $954.99 | $954.99 | $954.99 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $478.63 Median $478.63 Typical High $478.63 | Facility | 56 · Pre-op care only | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2,398.83 Median $2,398.83 Typical High $2,884.03 | Professional | 52 · Reduced service | $2,398.83 | $2,398.83 | $2,884.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $954.99 Median $954.99 Typical High $1,148.15 | Professional | 53 · Discontinued | $954.99 | $954.99 | $1,148.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $478.63 Median $478.63 Typical High $575.44 | Professional | 56 · Pre-op care only | $478.63 | $478.63 | $575.44 |
BCBS Minnesota Setting Professional Modifier 62 · Two surgeons Typical Low $4,786.30 Median $6,309.57 Typical High $10,232.93 | Professional | 62 · Two surgeons | $4,786.30 | $6,309.57 | $10,232.93 |
Where Minnesota sits
The same service costs 8.4 times more in Wisconsin 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
WI $28,671TX $3,407
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.