How much rates vary
Facilitymedian $2,344 · 10th to 90th $1,000 to $6,026Professionalmedian $3,020 · 10th to 90th $1,514 to $5,754
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 Facility Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $977.24 | Facility | 78 · Unplanned return to OR | $977.24 | $977.24 | $977.24 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,862.09 | Professional | None | $1,380.38 | $1,380.38 | $1,862.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $275.42 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $1,288.25 |
BCBS Minnesota Setting Facility Modifier None Typical Low $1,000.00 Median $2,570.40 Typical High $12,589.25 | Facility | None | $1,000.00 | $2,570.40 | $12,589.25 |
BCBS Minnesota Setting Professional Modifier None Typical Low $2,344.23 Median $3,090.30 Typical High $4,897.79 | Professional | None | $2,344.23 | $3,090.30 | $4,897.79 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $2,454.71 Typical High $3,890.45 | Professional | 54 · Surgery only | $1,905.46 | $2,454.71 | $3,890.45 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $478.63 Median $616.60 Typical High $977.24 | Professional | 55 · Aftercare only | $478.63 | $616.60 | $977.24 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,995.26 Median $2,570.40 Typical High $4,073.80 | Professional | 78 · Unplanned return to OR | $1,995.26 | $2,570.40 | $4,073.80 |
Cigna Setting Facility Modifier None Typical Low $2,398.83 Median $3,715.35 Typical High $7,079.46 | Facility | None | $2,398.83 | $3,715.35 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $3,467.37 Typical High $5,888.44 | Professional | None | $2,187.76 | $3,467.37 | $5,888.44 |
Health Partners Setting Facility Modifier None Typical Low $2,137.96 Median $3,467.37 Typical High $6,025.60 | Facility | None | $2,137.96 | $3,467.37 | $6,025.60 |
Health Partners Setting Professional Modifier None Typical Low $2,398.83 Median $3,235.94 Typical High $5,370.32 | Professional | None | $2,398.83 | $3,235.94 | $5,370.32 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,445.44 Typical High $3,467.37 | Facility | None | $758.58 | $1,445.44 | $3,467.37 |
Medica Setting Professional Modifier None Typical Low $1,698.24 Median $3,467.37 Typical High $11,220.18 | Professional | None | $1,698.24 | $3,467.37 | $11,220.18 |
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 $1,621.81 Median $2,630.27 Typical High $5,623.41 | Professional | None | $1,621.81 | $2,630.27 | $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 $281.84 Median $281.84 Typical High $281.84 | Facility | 53 · Discontinued | $281.84 | $281.84 | $281.84 |
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 $933.25 | Professional | 52 · Reduced service | $691.83 | $691.83 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $371.54 | Professional | 53 · Discontinued | $281.84 | $281.84 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $186.21 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $186.21 |
BCBS Minnesota Setting Professional Modifier 62 · Two surgeons Typical Low $1,479.11 Median $1,905.46 Typical High $3,019.95 | Professional | 62 · Two surgeons | $1,479.11 | $1,905.46 | $3,019.95 |
Where Minnesota sits
The same service costs 8.2 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 $17,891MD $2,184
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.