How much rates vary
Facilitymedian $1,995 · 10th to 90th $617 to $12,023Professionalmedian $1,259 · 10th to 90th $692 to $2,291
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 $616.60 Median $616.60 Typical High $616.60 | Facility | None | $616.60 | $616.60 | $616.60 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $457.09 | Facility | 54 · Surgery only | $457.09 | $457.09 | $457.09 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $426.58 | Facility | 78 · Unplanned return to OR | $426.58 | $426.58 | $426.58 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $758.58 | Professional | None | $616.60 | $616.60 | $758.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $549.54 | Professional | 54 · Surgery only | $457.09 | $457.09 | $549.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $426.58 | $426.58 | $512.86 |
BCBS Minnesota Setting Facility Modifier None Typical Low $7,079.46 Median $12,302.69 Typical High $23,988.33 | Facility | None | $7,079.46 | $12,302.69 | $23,988.33 |
BCBS Minnesota Setting Professional Modifier None Typical Low $933.25 Median $1,258.93 Typical High $2,041.74 | Professional | None | $933.25 | $1,258.93 | $2,041.74 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $1,000.00 Typical High $1,621.81 | Professional | 54 · Surgery only | $741.31 | $1,000.00 | $1,621.81 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $1,047.13 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $776.25 | $1,047.13 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $1,380.38 Typical High $2,630.27 | Facility | None | $891.25 | $1,380.38 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,548.82 Typical High $2,398.83 | Professional | None | $1,023.29 | $1,548.82 | $2,398.83 |
Health Partners Setting Facility Modifier None Typical Low $794.33 Median $1,258.93 Typical High $2,238.72 | Facility | None | $794.33 | $1,258.93 | $2,238.72 |
Health Partners Setting Professional Modifier None Typical Low $891.25 Median $1,348.96 Typical High $2,187.76 | Professional | None | $891.25 | $1,348.96 | $2,187.76 |
Medica Setting Facility Modifier None Typical Low $933.25 Median $4,365.16 Typical High $9,332.54 | Facility | None | $933.25 | $4,365.16 | $9,332.54 |
Medica Setting Professional Modifier None Typical Low $741.31 Median $1,174.90 Typical High $2,398.83 | Professional | None | $741.31 | $1,174.90 | $2,398.83 |
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 $691.83 Median $1,174.90 Typical High $2,454.71 | Professional | None | $691.83 | $1,174.90 | $2,454.71 |
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 $309.03 Median $309.03 Typical High $309.03 | Facility | 52 · Reduced service | $309.03 | $309.03 | $309.03 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | 53 · Discontinued | $123.03 | $123.03 | $123.03 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | 55 · Aftercare only | $91.20 | $91.20 | $91.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | 56 · Pre-op care only | $61.66 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $309.03 Median $309.03 Typical High $371.54 | Professional | 52 · Reduced service | $309.03 | $309.03 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $147.91 | Professional | 53 · Discontinued | $123.03 | $123.03 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $109.65 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $74.13 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $74.13 |
BCBS Minnesota Setting Facility Modifier 50 · Both sides Typical Low $10,715.19 Median $19,952.62 Typical High $36,307.81 | Facility | 50 · Both sides | $10,715.19 | $19,952.62 | $36,307.81 |
BCBS Minnesota Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $1,862.09 Typical High $3,090.30 | Professional | 50 · Both sides | $1,380.38 | $1,862.09 | $3,090.30 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $251.19 Typical High $407.38 | Professional | 55 · Aftercare only | $186.21 | $251.19 | $407.38 |
BCBS Minnesota Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $776.25 Typical High $1,258.93 | Professional | 62 · Two surgeons | $575.44 | $776.25 | $1,258.93 |
Where Minnesota sits
The same service costs 5.6 times more in Wisconsin than in Montana. 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 $10,313MT $1,845
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.