How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,122 to $10,000Professionalmedian $5,012 · 10th to 90th $2,818 to $9,120
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 $2,454.71 Median $2,454.71 Typical High $2,454.71 | Facility | None | $2,454.71 | $2,454.71 | $2,454.71 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Facility | 54 · Surgery only | $1,862.09 | $1,862.09 | $1,862.09 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | 55 · Aftercare only | $371.54 | $371.54 | $371.54 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Facility | 78 · Unplanned return to OR | $1,737.80 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,951.21 | Professional | None | $2,454.71 | $2,454.71 | $2,951.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $1,862.09 Typical High $2,238.72 | Professional | 54 · Surgery only | $1,862.09 | $1,862.09 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $371.54 Typical High $446.68 | Professional | 55 · Aftercare only | $371.54 | $371.54 | $446.68 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $1,737.80 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $1,737.80 | $1,737.80 | $2,089.30 |
BCBS Minnesota Setting Facility Modifier None Typical Low $4,786.30 Median $10,000.00 Typical High $23,988.33 | Facility | None | $4,786.30 | $10,000.00 | $23,988.33 |
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 $1,584.89 | Professional | 55 · Aftercare only | $758.58 | $1,000.00 | $1,584.89 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,162.28 Median $4,168.69 Typical High $6,760.83 | Professional | 78 · Unplanned return to OR | $3,162.28 | $4,168.69 | $6,760.83 |
Cigna Setting Facility Modifier None Typical Low $3,548.13 Median $5,495.41 Typical High $10,715.19 | Facility | None | $3,548.13 | $5,495.41 | $10,715.19 |
Cigna Setting Professional Modifier None Typical Low $4,168.69 Median $6,165.95 Typical High $9,549.93 | Professional | None | $4,168.69 | $6,165.95 | $9,549.93 |
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 $5,370.32 Typical High $8,912.51 | Professional | None | $3,630.78 | $5,370.32 | $8,912.51 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,445.44 Typical High $4,365.16 | Facility | None | $758.58 | $1,445.44 | $4,365.16 |
Medica Setting Professional Modifier None Typical Low $2,818.38 Median $4,677.35 Typical High $9,549.93 | Professional | None | $2,818.38 | $4,677.35 | $9,549.93 |
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 $2,754.23 Median $4,677.35 Typical High $9,772.37 | Professional | None | $2,754.23 | $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 $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | 52 · Reduced service | $1,230.27 | $1,230.27 | $1,230.27 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | 53 · Discontinued | $489.78 | $489.78 | $489.78 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | 56 · Pre-op care only | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1,230.27 Median $1,230.27 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,230.27 | $1,230.27 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $489.78 Typical High $588.84 | Professional | 53 · Discontinued | $489.78 | $489.78 | $588.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $245.47 Typical High $295.12 | Professional | 56 · Pre-op care only | $245.47 | $245.47 | $295.12 |
BCBS Minnesota Setting Professional Modifier 62 · Two surgeons Typical Low $2,344.23 Median $3,090.30 Typical High $4,897.79 | Professional | 62 · Two surgeons | $2,344.23 | $3,090.30 | $4,897.79 |
Where Minnesota sits
The same service costs 7.2 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 $21,573WA $2,995
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.