How much rates vary
Facilitymedian $2,239 · 10th to 90th $1,072 to $9,333Professionalmedian $2,754 · 10th to 90th $1,514 to $5,012
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 $1,348.96 Median $1,348.96 Typical High $1,348.96 | Facility | None | $1,348.96 | $1,348.96 | $1,348.96 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Facility | 54 · Surgery only | $1,000.00 | $1,000.00 | $1,000.00 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $933.25 | Facility | 78 · Unplanned return to OR | $933.25 | $933.25 | $933.25 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,698.24 | Professional | None | $1,348.96 | $1,348.96 | $1,698.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $1,202.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $1,122.02 |
BCBS Minnesota Setting Facility Modifier None Typical Low $7,079.46 Median $10,715.19 Typical High $20,417.38 | Facility | None | $7,079.46 | $10,715.19 | $20,417.38 |
BCBS Minnesota Setting Professional Modifier None Typical Low $2,041.74 Median $2,754.23 Typical High $4,466.84 | Professional | None | $2,041.74 | $2,754.23 | $4,466.84 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $2,187.76 Typical High $3,630.78 | Professional | 54 · Surgery only | $1,621.81 | $2,187.76 | $3,630.78 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $2,344.23 Typical High $3,801.89 | Professional | 78 · Unplanned return to OR | $1,698.24 | $2,344.23 | $3,801.89 |
Cigna Setting Facility Modifier None Typical Low $1,949.84 Median $3,019.95 Typical High $5,754.40 | Facility | None | $1,949.84 | $3,019.95 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $2,238.72 Median $3,388.44 Typical High $5,248.07 | Professional | None | $2,238.72 | $3,388.44 | $5,248.07 |
Health Partners Setting Facility Modifier None Typical Low $1,737.80 Median $2,818.38 Typical High $4,897.79 | Facility | None | $1,737.80 | $2,818.38 | $4,897.79 |
Health Partners Setting Professional Modifier None Typical Low $1,949.84 Median $2,951.21 Typical High $4,786.30 | Professional | None | $1,949.84 | $2,951.21 | $4,786.30 |
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 $1,659.59 Median $2,691.53 Typical High $5,248.07 | Professional | None | $1,659.59 | $2,691.53 | $5,248.07 |
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 $1,513.56 Median $2,570.40 Typical High $5,495.41 | Professional | None | $1,513.56 | $2,570.40 | $5,495.41 |
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 $676.08 Median $676.08 Typical High $676.08 | Facility | 52 · Reduced service | $676.08 | $676.08 | $676.08 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $269.15 | Facility | 53 · Discontinued | $269.15 | $269.15 | $269.15 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $199.53 | Facility | 55 · Aftercare only | $199.53 | $199.53 | $199.53 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | 56 · Pre-op care only | $134.90 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $676.08 Median $676.08 Typical High $812.83 | Professional | 52 · Reduced service | $676.08 | $676.08 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $323.59 | Professional | 53 · Discontinued | $269.15 | $269.15 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $245.47 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $162.18 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $162.18 |
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 $3,090.30 Median $4,168.69 Typical High $6,760.83 | Professional | 50 · Both sides | $3,090.30 | $4,168.69 | $6,760.83 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $549.54 Typical High $891.25 | Professional | 55 · Aftercare only | $407.38 | $549.54 | $891.25 |
BCBS Minnesota Setting Professional Modifier 62 · Two surgeons Typical Low $1,288.25 Median $1,737.80 Typical High $2,818.38 | Professional | 62 · Two surgeons | $1,288.25 | $1,737.80 | $2,818.38 |
Where Minnesota sits
The same service costs 7.6 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 $16,031MD $2,111
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.