How much rates vary
Facilitymedian $2,455 · 10th to 90th $1,122 to $7,244Professionalmedian $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 $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
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 $1,318.26 Median $1,318.26 Typical High $1,698.24 | Professional | None | $1,318.26 | $1,318.26 | $1,698.24 |
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 $2,041.74 Median $2,754.23 Typical High $4,786.30 | Professional | None | $2,041.74 | $2,754.23 | $4,786.30 |
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 $1,621.81 Median $2,951.21 Typical High $11,481.54 | Professional | None | $1,621.81 | $2,951.21 | $11,481.54 |
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 $660.69 Median $660.69 Typical High $660.69 | Facility | 52 · Reduced service | $660.69 | $660.69 | $660.69 |
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 $131.83 Median $131.83 Typical High $131.83 | Facility | 56 · Pre-op care only | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $660.69 Median $660.69 Typical High $758.58 | Professional | 52 · Reduced service | $660.69 | $660.69 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $309.03 | Professional | 53 · Discontinued | $263.03 | $263.03 | $309.03 |
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 $131.83 Median $131.83 Typical High $154.88 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $154.88 |
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 $3,019.95 | Professional | 62 · Two surgeons | $1,258.93 | $1,698.24 | $3,019.95 |
Where Minnesota sits
The same service costs 13.9 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 $28,165MD $2,021
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.