How much rates vary
Facilitymedian $2,818 · 10th to 90th $891 to $11,749Professionalmedian $1,995 · 10th to 90th $955 to $3,802
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 $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | 54 · Surgery only | $676.08 | $676.08 | $676.08 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | 78 · Unplanned return to OR | $630.96 | $630.96 | $630.96 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,122.02 | Professional | None | $891.25 | $891.25 | $1,122.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $776.25 | Professional | 54 · Surgery only | $676.08 | $676.08 | $776.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $724.44 |
BCBS Minnesota Setting Facility Modifier None Typical Low $5,128.61 Median $16,595.87 Typical High $39,810.72 | Facility | None | $5,128.61 | $16,595.87 | $39,810.72 |
BCBS Minnesota Setting Professional Modifier None Typical Low $1,380.38 Median $1,905.46 Typical High $3,235.94 | Professional | None | $1,380.38 | $1,905.46 | $3,235.94 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,513.56 Typical High $2,630.27 | Professional | 54 · Surgery only | $1,122.02 | $1,513.56 | $2,630.27 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,584.89 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,584.89 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $2,290.87 Typical High $4,365.16 | Facility | None | $1,479.11 | $2,290.87 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $2,630.27 Typical High $4,168.69 | Professional | None | $1,698.24 | $2,630.27 | $4,168.69 |
Health Partners Setting Facility Modifier None Typical Low $1,318.26 Median $2,137.96 Typical High $3,715.35 | Facility | None | $1,318.26 | $2,137.96 | $3,715.35 |
Health Partners Setting Professional Modifier None Typical Low $1,479.11 Median $2,398.83 Typical High $3,630.78 | Professional | None | $1,479.11 | $2,398.83 | $3,630.78 |
Medica Setting Facility Modifier None Typical Low $1,445.44 Median $3,467.37 Typical High $9,772.37 | Facility | None | $1,445.44 | $3,467.37 | $9,772.37 |
Medica Setting Professional Modifier None Typical Low $1,096.48 Median $2,041.74 Typical High $6,760.83 | Professional | None | $1,096.48 | $2,041.74 | $6,760.83 |
United Setting Facility Modifier None Typical Low $2,818.38 Median $4,265.80 Typical High $11,220.18 | Facility | None | $2,818.38 | $4,265.80 | $11,220.18 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,905.46 Typical High $3,715.35 | Professional | None | $1,023.29 | $1,905.46 | $3,715.35 |
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 $446.68 Median $446.68 Typical High $446.68 | Facility | 52 · Reduced service | $446.68 | $446.68 | $446.68 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $177.83 | Facility | 53 · Discontinued | $177.83 | $177.83 | $177.83 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | 55 · Aftercare only | $134.90 | $134.90 | $134.90 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | 56 · Pre-op care only | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $446.68 Median $446.68 Typical High $524.81 | Professional | 52 · Reduced service | $446.68 | $446.68 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $208.93 | Professional | 53 · Discontinued | $177.83 | $177.83 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $158.49 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $104.71 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $104.71 |
BCBS Minnesota Setting Facility Modifier 50 · Both sides Typical Low $20,417.38 Median $37,153.52 Typical High $69,183.10 | Facility | 50 · Both sides | $20,417.38 | $37,153.52 | $69,183.10 |
BCBS Minnesota Setting Professional Modifier 50 · Both sides Typical Low $2,089.30 Median $2,818.38 Typical High $4,897.79 | Professional | 50 · Both sides | $2,089.30 | $2,818.38 | $4,897.79 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $380.19 Typical High $645.65 | Professional | 55 · Aftercare only | $281.84 | $380.19 | $645.65 |
BCBS Minnesota Setting Professional Modifier 62 · Two surgeons Typical Low $870.96 Median $1,174.90 Typical High $1,995.26 | Professional | 62 · Two surgeons | $870.96 | $1,174.90 | $1,995.26 |
Where Minnesota sits
The same service costs 4.6 times more in Wyoming than in Montana. 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
WY $13,103MT $2,825
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.