How much rates vary
Facilitymedian $1,514 · 10th to 90th $813 to $7,079Professionalmedian $1,660 · 10th to 90th $1,000 to $3,020
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 $812.83 Median $812.83 Typical High $812.83 | Facility | None | $812.83 | $812.83 | $812.83 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $616.60 | Facility | 54 · Surgery only | $616.60 | $616.60 | $616.60 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | 55 · Aftercare only | $123.03 | $123.03 | $123.03 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $575.44 | Facility | 78 · Unplanned return to OR | $575.44 | $575.44 | $575.44 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,000.00 | Professional | None | $812.83 | $812.83 | $1,000.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $741.31 | Professional | 54 · Surgery only | $616.60 | $616.60 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $147.91 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $691.83 |
BCBS Minnesota Setting Facility Modifier None Typical Low $4,365.16 Median $9,772.37 Typical High $21,379.62 | Facility | None | $4,365.16 | $9,772.37 | $21,379.62 |
BCBS Minnesota Setting Professional Modifier None Typical Low $1,230.27 Median $1,659.59 Typical High $2,691.53 | Professional | None | $1,230.27 | $1,659.59 | $2,691.53 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,318.26 Typical High $2,137.96 | Professional | 54 · Surgery only | $977.24 | $1,318.26 | $2,137.96 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $331.13 Typical High $524.81 | Professional | 55 · Aftercare only | $245.47 | $331.13 | $524.81 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,380.38 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,380.38 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $1,819.70 Typical High $3,467.37 | Facility | None | $1,174.90 | $1,819.70 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $2,041.74 Typical High $3,162.28 | Professional | None | $1,380.38 | $2,041.74 | $3,162.28 |
Health Partners Setting Facility Modifier None Typical Low $1,047.13 Median $1,698.24 Typical High $2,951.21 | Facility | None | $1,047.13 | $1,698.24 | $2,951.21 |
Health Partners Setting Professional Modifier None Typical Low $1,174.90 Median $1,778.28 Typical High $2,884.03 | Professional | None | $1,174.90 | $1,778.28 | $2,884.03 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,412.54 Typical High $3,019.95 | Facility | None | $758.58 | $1,412.54 | $3,019.95 |
Medica Setting Professional Modifier None Typical Low $1,000.00 Median $1,584.89 Typical High $3,235.94 | Professional | None | $1,000.00 | $1,584.89 | $3,235.94 |
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 $933.25 Median $1,584.89 Typical High $3,311.31 | Professional | None | $933.25 | $1,584.89 | $3,311.31 |
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 $407.38 Median $407.38 Typical High $407.38 | Facility | 52 · Reduced service | $407.38 | $407.38 | $407.38 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | 53 · Discontinued | $162.18 | $162.18 | $162.18 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | 56 · Pre-op care only | $81.28 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $407.38 Median $407.38 Typical High $489.78 | Professional | 52 · Reduced service | $407.38 | $407.38 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $194.98 | Professional | 53 · Discontinued | $162.18 | $162.18 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $97.72 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $97.72 |
BCBS Minnesota Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $1,023.29 Typical High $1,621.81 | Professional | 62 · Two surgeons | $758.58 | $1,023.29 | $1,621.81 |
Where Minnesota sits
The same service costs 18.7 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 $26,826MD $1,433
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.