How much rates vary
Facilitymedian $2,291 · 10th to 90th $1,047 to $5,129Professionalmedian $2,754 · 10th to 90th $1,318 to $5,248
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 $1,258.93 Median $1,258.93 Typical High $1,258.93 | Facility | None | $1,258.93 | $1,258.93 | $1,258.93 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $933.25 | Facility | 54 · Surgery only | $933.25 | $933.25 | $933.25 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $870.96 | Facility | 78 · Unplanned return to OR | $870.96 | $870.96 | $870.96 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,513.56 | Professional | None | $1,258.93 | $1,258.93 | $1,513.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $1,096.48 | Professional | 54 · Surgery only | $933.25 | $933.25 | $1,096.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $1,023.29 |
BCBS Minnesota Setting Facility Modifier None Typical Low $2,570.40 Median $4,265.80 Typical High $7,762.47 | Facility | None | $2,570.40 | $4,265.80 | $7,762.47 |
BCBS Minnesota Setting Professional Modifier None Typical Low $1,949.84 Median $2,630.27 Typical High $4,570.88 | Professional | None | $1,949.84 | $2,630.27 | $4,570.88 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $2,089.30 Typical High $3,630.78 | Professional | 54 · Surgery only | $1,548.82 | $2,089.30 | $3,630.78 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $2,187.76 Typical High $3,801.89 | Professional | 78 · Unplanned return to OR | $1,621.81 | $2,187.76 | $3,801.89 |
Cigna Setting Facility Modifier None Typical Low $2,041.74 Median $3,162.28 Typical High $6,025.60 | Facility | None | $2,041.74 | $3,162.28 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $2,344.23 Median $3,630.78 Typical High $5,754.40 | Professional | None | $2,344.23 | $3,630.78 | $5,754.40 |
Health Partners Setting Facility Modifier None Typical Low $1,819.70 Median $2,951.21 Typical High $5,128.61 | Facility | None | $1,819.70 | $2,951.21 | $5,128.61 |
Health Partners Setting Professional Modifier None Typical Low $2,041.74 Median $3,311.31 Typical High $5,011.87 | Professional | None | $2,041.74 | $3,311.31 | $5,011.87 |
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 $1,513.56 Median $2,818.38 Typical High $11,220.18 | Professional | None | $1,513.56 | $2,818.38 | $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 $1,445.44 Median $2,630.27 Typical High $5,248.07 | Professional | None | $1,445.44 | $2,630.27 | $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 $616.60 Median $616.60 Typical High $616.60 | Facility | 52 · Reduced service | $616.60 | $616.60 | $616.60 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | 53 · Discontinued | $251.19 | $251.19 | $251.19 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $186.21 | Facility | 55 · Aftercare only | $186.21 | $186.21 | $186.21 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | 56 · Pre-op care only | $125.89 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $616.60 Median $616.60 Typical High $724.44 | Professional | 52 · Reduced service | $616.60 | $616.60 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $295.12 | Professional | 53 · Discontinued | $251.19 | $251.19 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $218.78 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $144.54 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $144.54 |
BCBS Minnesota Setting Facility Modifier 50 · Both sides Typical Low $4,073.80 Median $7,413.10 Typical High $13,489.63 | Facility | 50 · Both sides | $4,073.80 | $7,413.10 | $13,489.63 |
BCBS Minnesota Setting Professional Modifier 50 · Both sides Typical Low $2,884.03 Median $3,981.07 Typical High $6,760.83 | Professional | 50 · Both sides | $2,884.03 | $3,981.07 | $6,760.83 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $524.81 Typical High $891.25 | Professional | 55 · Aftercare only | $389.05 | $524.81 | $891.25 |
BCBS Minnesota Setting Professional Modifier 62 · Two surgeons Typical Low $1,202.26 Median $1,659.59 Typical High $2,754.23 | Professional | 62 · Two surgeons | $1,202.26 | $1,659.59 | $2,754.23 |
Where Minnesota sits
The same service costs 12.5 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 $24,646MD $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.