How much rates vary
Facilitymedian $3,236 · 10th to 90th $1,122 to $8,511Professionalmedian $3,981 · 10th to 90th $2,399 to $7,413
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 $1,995.26 Median $1,995.26 Typical High $1,995.26 | Facility | None | $1,995.26 | $1,995.26 | $1,995.26 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Facility | 54 · Surgery only | $1,513.56 | $1,513.56 | $1,513.56 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | 55 · Aftercare only | $302.00 | $302.00 | $302.00 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Facility | 78 · Unplanned return to OR | $1,412.54 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,398.83 | Professional | None | $1,995.26 | $1,995.26 | $2,398.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,513.56 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,513.56 | $1,513.56 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $302.00 Typical High $363.08 | Professional | 55 · Aftercare only | $302.00 | $302.00 | $363.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,412.54 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,412.54 | $1,659.59 |
BCBS Minnesota Setting Facility Modifier None Typical Low $3,801.89 Median $8,128.31 Typical High $19,498.45 | Facility | None | $3,801.89 | $8,128.31 | $19,498.45 |
BCBS Minnesota Setting Professional Modifier None Typical Low $3,019.95 Median $3,981.07 Typical High $6,606.93 | Professional | None | $3,019.95 | $3,981.07 | $6,606.93 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $2,398.83 Median $3,235.94 Typical High $5,248.07 | Professional | 54 · Surgery only | $2,398.83 | $3,235.94 | $5,248.07 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $602.56 Median $812.83 Typical High $1,288.25 | Professional | 55 · Aftercare only | $602.56 | $812.83 | $1,288.25 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,511.89 Median $3,388.44 Typical High $5,495.41 | Professional | 78 · Unplanned return to OR | $2,511.89 | $3,388.44 | $5,495.41 |
Cigna Setting Facility Modifier None Typical Low $2,884.03 Median $4,466.84 Typical High $8,511.38 | Facility | None | $2,884.03 | $4,466.84 | $8,511.38 |
Cigna Setting Professional Modifier None Typical Low $3,388.44 Median $5,011.87 Typical High $7,762.47 | Professional | None | $3,388.44 | $5,011.87 | $7,762.47 |
Health Partners Setting Facility Modifier None Typical Low $2,570.40 Median $4,168.69 Typical High $7,244.36 | Facility | None | $2,570.40 | $4,168.69 | $7,244.36 |
Health Partners Setting Professional Modifier None Typical Low $2,884.03 Median $4,365.16 Typical High $7,079.46 | Professional | None | $2,884.03 | $4,365.16 | $7,079.46 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,445.44 Typical High $3,548.13 | Facility | None | $758.58 | $1,445.44 | $3,548.13 |
Medica Setting Professional Modifier None Typical Low $2,344.23 Median $3,801.89 Typical High $7,762.47 | Professional | None | $2,344.23 | $3,801.89 | $7,762.47 |
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 $2,238.72 Median $3,801.89 Typical High $7,943.28 | Professional | None | $2,238.72 | $3,801.89 | $7,943.28 |
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 $1,000.00 Median $1,000.00 Typical High $1,000.00 | Facility | 52 · Reduced service | $1,000.00 | $1,000.00 | $1,000.00 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | 53 · Discontinued | $398.11 | $398.11 | $398.11 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $199.53 Median $199.53 Typical High $199.53 | Facility | 56 · Pre-op care only | $199.53 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1,000.00 Median $1,000.00 Typical High $1,202.26 | Professional | 52 · Reduced service | $1,000.00 | $1,000.00 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $398.11 Typical High $478.63 | Professional | 53 · Discontinued | $398.11 | $398.11 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $199.53 Typical High $239.88 | Professional | 56 · Pre-op care only | $199.53 | $199.53 | $239.88 |
BCBS Minnesota Setting Professional Modifier 62 · Two surgeons Typical Low $1,862.09 Median $2,511.89 Typical High $3,981.07 | Professional | 62 · Two surgeons | $1,862.09 | $2,511.89 | $3,981.07 |
Where Minnesota sits
The same service costs 8.0 times more in Alabama 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
AL $20,353WA $2,540
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.