How much rates vary
Facilitymedian $2,188 · 10th to 90th $1,072 to $7,762Professionalmedian $2,692 · 10th to 90th $1,514 to $4,786
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 $1,288.25 Median $1,288.25 Typical High $1,288.25 | Facility | None | $1,288.25 | $1,288.25 | $1,288.25 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $954.99 | Facility | 54 · Surgery only | $954.99 | $954.99 | $954.99 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $912.01 | Facility | 78 · Unplanned return to OR | $912.01 | $912.01 | $912.01 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,621.81 | Professional | None | $1,288.25 | $1,288.25 | $1,621.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $1,174.90 | Professional | 54 · Surgery only | $954.99 | $954.99 | $1,174.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $1,096.48 |
BCBS Minnesota Setting Facility Modifier None Typical Low $4,168.69 Median $7,762.47 Typical High $13,803.84 | Facility | None | $4,168.69 | $7,762.47 | $13,803.84 |
BCBS Minnesota Setting Professional Modifier None Typical Low $1,949.84 Median $2,691.53 Typical High $4,365.16 | Professional | None | $1,949.84 | $2,691.53 | $4,365.16 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $2,137.96 Typical High $3,467.37 | Professional | 54 · Surgery only | $1,584.89 | $2,137.96 | $3,467.37 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $2,238.72 Typical High $3,630.78 | Professional | 78 · Unplanned return to OR | $1,659.59 | $2,238.72 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $1,862.09 Median $2,884.03 Typical High $5,495.41 | Facility | None | $1,862.09 | $2,884.03 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $3,235.94 Typical High $5,011.87 | Professional | None | $2,187.76 | $3,235.94 | $5,011.87 |
Health Partners Setting Facility Modifier None Typical Low $1,659.59 Median $2,691.53 Typical High $4,677.35 | Facility | None | $1,659.59 | $2,691.53 | $4,677.35 |
Health Partners Setting Professional Modifier None Typical Low $1,862.09 Median $2,818.38 Typical High $4,570.88 | Professional | None | $1,862.09 | $2,818.38 | $4,570.88 |
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 $1,584.89 Median $2,511.89 Typical High $5,011.87 | Professional | None | $1,584.89 | $2,511.89 | $5,011.87 |
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 $1,479.11 Median $2,454.71 Typical High $5,248.07 | Professional | None | $1,479.11 | $2,454.71 | $5,248.07 |
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 $645.65 Median $645.65 Typical High $645.65 | Facility | 52 · Reduced service | $645.65 | $645.65 | $645.65 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $257.04 | Facility | 53 · Discontinued | $257.04 | $257.04 | $257.04 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $194.98 | Facility | 55 · Aftercare only | $194.98 | $194.98 | $194.98 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | 56 · Pre-op care only | $128.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $645.65 Median $645.65 Typical High $776.25 | Professional | 52 · Reduced service | $645.65 | $645.65 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $309.03 | Professional | 53 · Discontinued | $257.04 | $257.04 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $234.42 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $154.88 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $154.88 |
BCBS Minnesota Setting Facility Modifier 50 · Both sides Typical Low $6,309.57 Median $11,748.98 Typical High $20,892.96 | Facility | 50 · Both sides | $6,309.57 | $11,748.98 | $20,892.96 |
BCBS Minnesota Setting Professional Modifier 50 · Both sides Typical Low $2,951.21 Median $3,981.07 Typical High $6,606.93 | Professional | 50 · Both sides | $2,951.21 | $3,981.07 | $6,606.93 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $398.11 Median $537.03 Typical High $870.96 | Professional | 55 · Aftercare only | $398.11 | $537.03 | $870.96 |
BCBS Minnesota Setting Professional Modifier 62 · Two surgeons Typical Low $1,230.27 Median $1,659.59 Typical High $2,691.53 | Professional | 62 · Two surgeons | $1,230.27 | $1,659.59 | $2,691.53 |
Where Minnesota sits
The same service costs 8.1 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 $15,945MD $1,975
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.