How much rates vary
Facilitymedian $2,291 · 10th to 90th $1,072 to $6,166Professionalmedian $2,692 · 10th to 90th $1,445 to $5,129
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 $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,230.27 | $1,230.27 | $1,230.27 |
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 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 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 $1,230.27 Median $1,230.27 Typical High $1,445.44 | Professional | None | $1,230.27 | $1,230.27 | $1,445.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $1,071.52 | Professional | 54 · Surgery only | $933.25 | $933.25 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $213.80 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $1,000.00 |
BCBS Minnesota Setting Facility Modifier None Typical Low $2,951.21 Median $6,025.60 Typical High $13,182.57 | Facility | None | $2,951.21 | $6,025.60 | $13,182.57 |
BCBS Minnesota Setting Professional Modifier None Typical Low $1,905.46 Median $2,570.40 Typical High $4,365.16 | Professional | None | $1,905.46 | $2,570.40 | $4,365.16 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $2,089.30 Typical High $3,467.37 | Professional | 54 · Surgery only | $1,548.82 | $2,089.30 | $3,467.37 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $524.81 Typical High $870.96 | Professional | 55 · Aftercare only | $380.19 | $524.81 | $870.96 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $2,187.76 Typical High $3,715.35 | Professional | 78 · Unplanned return to OR | $1,621.81 | $2,187.76 | $3,715.35 |
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 $2,290.87 Median $3,630.78 Typical High $5,754.40 | Professional | None | $2,290.87 | $3,630.78 | $5,754.40 |
Health Partners Setting Facility Modifier None Typical Low $1,819.70 Median $2,884.03 Typical High $5,011.87 | Facility | None | $1,819.70 | $2,884.03 | $5,011.87 |
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 $1,479.11 Median $2,754.23 Typical High $21,877.62 | Professional | None | $1,479.11 | $2,754.23 | $21,877.62 |
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 $1,412.54 Median $2,570.40 Typical High $5,128.61 | Professional | None | $1,412.54 | $2,570.40 | $5,128.61 |
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 $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 $245.47 Median $245.47 Typical High $245.47 | Facility | 53 · Discontinued | $245.47 | $245.47 | $245.47 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | 56 · Pre-op care only | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $616.60 Median $616.60 Typical High $707.95 | Professional | 52 · Reduced service | $616.60 | $616.60 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $288.40 | Professional | 53 · Discontinued | $245.47 | $245.47 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $141.25 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $141.25 |
BCBS Minnesota Setting Professional Modifier 62 · Two surgeons Typical Low $1,202.26 Median $1,621.81 Typical High $2,691.53 | Professional | 62 · Two surgeons | $1,202.26 | $1,621.81 | $2,691.53 |
Where Minnesota sits
The same service costs 9.0 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 $17,266MD $1,911
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.