How much rates vary
Facilitymedian $3,162 · 10th to 90th $1,288 to $14,791Professionalmedian $2,884 · 10th to 90th $1,380 to $5,495
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 $1,288.25 Median $14,791.08 Typical High $14,791.08 | Facility | None | $1,288.25 | $14,791.08 | $14,791.08 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $977.24 | Facility | 54 · Surgery only | $977.24 | $977.24 | $977.24 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $912.01 | Facility | 78 · Unplanned return to OR | $912.01 | $912.01 | $912.01 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,621.81 | Professional | None | $1,288.25 | $1,288.25 | $1,621.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $1,148.15 | Professional | 54 · Surgery only | $977.24 | $977.24 | $1,148.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $1,071.52 |
BCBS Minnesota Setting Facility Modifier None Typical Low $2,754.23 Median $7,244.36 Typical High $14,454.40 | Facility | None | $2,754.23 | $7,244.36 | $14,454.40 |
BCBS Minnesota Setting Professional Modifier None Typical Low $1,995.26 Median $2,754.23 Typical High $4,677.35 | Professional | None | $1,995.26 | $2,754.23 | $4,677.35 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $2,187.76 Typical High $3,801.89 | Professional | 54 · Surgery only | $1,621.81 | $2,187.76 | $3,801.89 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $2,290.87 Typical High $3,981.07 | Professional | 78 · Unplanned return to OR | $1,698.24 | $2,290.87 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $2,137.96 Median $3,311.31 Typical High $6,309.57 | Facility | None | $2,137.96 | $3,311.31 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $2,454.71 Median $3,801.89 Typical High $6,025.60 | Professional | None | $2,454.71 | $3,801.89 | $6,025.60 |
Health Partners Setting Facility Modifier None Typical Low $1,905.46 Median $3,090.30 Typical High $5,370.32 | Facility | None | $1,905.46 | $3,090.30 | $5,370.32 |
Health Partners Setting Professional Modifier None Typical Low $2,137.96 Median $3,467.37 Typical High $5,248.07 | Professional | None | $2,137.96 | $3,467.37 | $5,248.07 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,513.56 Typical High $3,467.37 | Facility | None | $758.58 | $1,513.56 | $3,467.37 |
Medica Setting Professional Modifier None Typical Low $1,584.89 Median $2,951.21 Typical High $10,964.78 | Professional | None | $1,584.89 | $2,951.21 | $10,964.78 |
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 $2,754.23 Typical High $5,495.41 | Professional | None | $1,513.56 | $2,754.23 | $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 $645.65 Median $645.65 Typical High $645.65 | Facility | 52 · Reduced service | $645.65 | $645.65 | $645.65 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | 53 · Discontinued | $263.03 | $263.03 | $263.03 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $194.98 | Facility | 55 · Aftercare only | $194.98 | $194.98 | $194.98 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | 56 · Pre-op care only | $128.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $645.65 Median $645.65 Typical High $758.58 | Professional | 52 · Reduced service | $645.65 | $645.65 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $302.00 | Professional | 53 · Discontinued | $263.03 | $263.03 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $229.09 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $151.36 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $151.36 |
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 $3,019.95 Median $4,073.80 Typical High $7,079.46 | Professional | 50 · Both sides | $3,019.95 | $4,073.80 | $7,079.46 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $549.54 Typical High $933.25 | Professional | 55 · Aftercare only | $407.38 | $549.54 | $933.25 |
BCBS Minnesota Setting Professional Modifier 62 · Two surgeons Typical Low $1,258.93 Median $1,698.24 Typical High $2,951.21 | Professional | 62 · Two surgeons | $1,258.93 | $1,698.24 | $2,951.21 |
Where Minnesota sits
The same service costs 14.0 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 $28,122MD $2,008
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.