How much rates vary
Facilitymedian $2,692 · 10th to 90th $1,072 to $7,079Professionalmedian $3,467 · 10th to 90th $1,698 to $6,457
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 $1,584.89 Median $1,584.89 Typical High $1,584.89 | Facility | None | $1,584.89 | $1,584.89 | $1,584.89 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | 54 · Surgery only | $1,174.90 | $1,174.90 | $1,174.90 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | 55 · Aftercare only | $239.88 | $239.88 | $239.88 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Facility | 78 · Unplanned return to OR | $1,096.48 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $2,290.87 | Professional | None | $1,584.89 | $1,584.89 | $2,290.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,174.90 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,174.90 | $1,174.90 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $316.23 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $316.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,096.48 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,096.48 | $1,479.11 |
BCBS Minnesota Setting Facility Modifier None Typical Low $1,318.26 Median $3,388.44 Typical High $14,454.40 | Facility | None | $1,318.26 | $3,388.44 | $14,454.40 |
BCBS Minnesota Setting Professional Modifier None Typical Low $2,691.53 Median $3,467.37 Typical High $5,495.41 | Professional | None | $2,691.53 | $3,467.37 | $5,495.41 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $2,137.96 Median $2,754.23 Typical High $4,466.84 | Professional | 54 · Surgery only | $2,137.96 | $2,754.23 | $4,466.84 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $537.03 Median $691.83 Typical High $1,096.48 | Professional | 55 · Aftercare only | $537.03 | $691.83 | $1,096.48 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,238.72 Median $2,884.03 Typical High $4,677.35 | Professional | 78 · Unplanned return to OR | $2,238.72 | $2,884.03 | $4,677.35 |
Cigna Setting Facility Modifier None Typical Low $2,754.23 Median $4,265.80 Typical High $8,128.31 | Facility | None | $2,754.23 | $4,265.80 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $2,454.71 Median $3,890.45 Typical High $6,606.93 | Professional | None | $2,454.71 | $3,890.45 | $6,606.93 |
Health Partners Setting Facility Modifier None Typical Low $2,398.83 Median $3,890.45 Typical High $6,760.83 | Facility | None | $2,398.83 | $3,890.45 | $6,760.83 |
Health Partners Setting Professional Modifier None Typical Low $2,754.23 Median $3,630.78 Typical High $6,025.60 | Professional | None | $2,754.23 | $3,630.78 | $6,025.60 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,445.44 Typical High $3,548.13 | Facility | None | $758.58 | $1,445.44 | $3,548.13 |
Medica Setting Professional Modifier None Typical Low $1,862.09 Median $3,981.07 Typical High $12,882.50 | Professional | None | $1,862.09 | $3,981.07 | $12,882.50 |
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 $1,819.70 Median $3,019.95 Typical High $6,456.54 | Professional | None | $1,819.70 | $3,019.95 | $6,456.54 |
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 $794.33 Median $794.33 Typical High $794.33 | Facility | 52 · Reduced service | $794.33 | $794.33 | $794.33 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $316.23 Median $316.23 Typical High $316.23 | Facility | 53 · Discontinued | $316.23 | $316.23 | $316.23 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | 56 · Pre-op care only | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $794.33 Median $794.33 Typical High $1,047.13 | Professional | 52 · Reduced service | $794.33 | $794.33 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $316.23 Typical High $416.87 | Professional | 53 · Discontinued | $316.23 | $316.23 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $158.49 Typical High $208.93 | Professional | 56 · Pre-op care only | $158.49 | $158.49 | $208.93 |
BCBS Minnesota Setting Professional Modifier 62 · Two surgeons Typical Low $1,659.59 Median $2,187.76 Typical High $3,467.37 | Professional | 62 · Two surgeons | $1,659.59 | $2,187.76 | $3,467.37 |
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 $18,140MD $2,382
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.