How much rates vary
Facilitymedian $2,344 · 10th to 90th $1,072 to $10,000Professionalmedian $2,818 · 10th to 90th $1,698 to $5,129
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 $1,380.38 Median $1,380.38 Typical High $1,380.38 | Facility | None | $1,380.38 | $1,380.38 | $1,380.38 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Facility | 54 · Surgery only | $1,047.13 | $1,047.13 | $1,047.13 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | 55 · Aftercare only | $208.93 | $208.93 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,698.24 | Professional | None | $1,380.38 | $1,380.38 | $1,698.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $251.19 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $251.19 |
BCBS Minnesota Setting Facility Modifier None Typical Low $7,585.78 Median $11,220.18 Typical High $21,877.62 | Facility | None | $7,585.78 | $11,220.18 | $21,877.62 |
BCBS Minnesota Setting Professional Modifier None Typical Low $2,089.30 Median $2,818.38 Typical High $4,677.35 | Professional | None | $2,089.30 | $2,818.38 | $4,677.35 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $2,290.87 Typical High $3,715.35 | Professional | 54 · Surgery only | $1,698.24 | $2,290.87 | $3,715.35 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $562.34 Typical High $912.01 | Professional | 55 · Aftercare only | $416.87 | $562.34 | $912.01 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $2,398.83 Typical High $3,890.45 | Professional | 78 · Unplanned return to OR | $1,778.28 | $2,398.83 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $3,162.28 Typical High $6,025.60 | Facility | None | $1,995.26 | $3,162.28 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $2,344.23 Median $3,467.37 Typical High $5,370.32 | Professional | None | $2,344.23 | $3,467.37 | $5,370.32 |
Health Partners Setting Facility Modifier None Typical Low $1,778.28 Median $2,884.03 Typical High $5,011.87 | Facility | None | $1,778.28 | $2,884.03 | $5,011.87 |
Health Partners Setting Professional Modifier None Typical Low $2,041.74 Median $3,019.95 Typical High $5,011.87 | Professional | None | $2,041.74 | $3,019.95 | $5,011.87 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,445.44 Typical High $3,388.44 | Facility | None | $758.58 | $1,445.44 | $3,388.44 |
Medica Setting Professional Modifier None Typical Low $1,698.24 Median $2,691.53 Typical High $5,495.41 | Professional | None | $1,698.24 | $2,691.53 | $5,495.41 |
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 $1,584.89 Median $2,691.53 Typical High $5,623.41 | Professional | None | $1,584.89 | $2,691.53 | $5,623.41 |
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 $691.83 Median $691.83 Typical High $691.83 | Facility | 52 · Reduced service | $691.83 | $691.83 | $691.83 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $275.42 | Facility | 53 · Discontinued | $275.42 | $275.42 | $275.42 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | 56 · Pre-op care only | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $691.83 Median $691.83 Typical High $831.76 | Professional | 52 · Reduced service | $691.83 | $691.83 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $338.84 | Professional | 53 · Discontinued | $275.42 | $275.42 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $169.82 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $169.82 |
BCBS Minnesota Setting Professional Modifier 62 · Two surgeons Typical Low $1,318.26 Median $1,778.28 Typical High $2,818.38 | Professional | 62 · Two surgeons | $1,318.26 | $1,778.28 | $2,818.38 |
Where Minnesota sits
The same service costs 25.6 times more in Maine than in Maryland. 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
ME $53,236MD $2,076
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.