How much rates vary
Facilitymedian $2,089 · 10th to 90th $759 to $6,761Professionalmedian $1,622 · 10th to 90th $891 to $3,162
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 $758.58 Median $758.58 Typical High $758.58 | Facility | None | $758.58 | $758.58 | $758.58 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $575.44 | Facility | 54 · Surgery only | $575.44 | $575.44 | $575.44 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $114.82 | Facility | 55 · Aftercare only | $114.82 | $114.82 | $114.82 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $537.03 | Facility | 78 · Unplanned return to OR | $537.03 | $537.03 | $537.03 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $933.25 | Professional | None | $758.58 | $758.58 | $933.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $660.69 | Professional | 54 · Surgery only | $575.44 | $575.44 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $131.83 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $616.60 |
BCBS Minnesota Setting Facility Modifier None Typical Low $4,168.69 Median $6,606.93 Typical High $13,182.57 | Facility | None | $4,168.69 | $6,606.93 | $13,182.57 |
BCBS Minnesota Setting Professional Modifier None Typical Low $1,174.90 Median $1,584.89 Typical High $2,691.53 | Professional | None | $1,174.90 | $1,584.89 | $2,691.53 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,288.25 Typical High $2,137.96 | Professional | 54 · Surgery only | $954.99 | $1,288.25 | $2,137.96 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $323.59 Typical High $537.03 | Professional | 55 · Aftercare only | $234.42 | $323.59 | $537.03 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,348.96 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,348.96 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $1,258.93 Median $1,949.84 Typical High $3,715.35 | Facility | None | $1,258.93 | $1,949.84 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $2,238.72 Typical High $3,548.13 | Professional | None | $1,412.54 | $2,238.72 | $3,548.13 |
Health Partners Setting Facility Modifier None Typical Low $1,122.02 Median $1,778.28 Typical High $3,090.30 | Facility | None | $1,122.02 | $1,778.28 | $3,090.30 |
Health Partners Setting Professional Modifier None Typical Low $1,258.93 Median $2,041.74 Typical High $3,090.30 | Professional | None | $1,258.93 | $2,041.74 | $3,090.30 |
Medica Setting Facility Modifier None Typical Low $1,230.27 Median $2,754.23 Typical High $5,495.41 | Facility | None | $1,230.27 | $2,754.23 | $5,495.41 |
Medica Setting Professional Modifier None Typical Low $933.25 Median $1,698.24 Typical High $9,772.37 | Professional | None | $933.25 | $1,698.24 | $9,772.37 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $3,090.30 Typical High $6,760.83 | Facility | None | $1,995.26 | $3,090.30 | $6,760.83 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,584.89 Typical High $3,162.28 | Professional | None | $870.96 | $1,584.89 | $3,162.28 |
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 $380.19 Median $380.19 Typical High $380.19 | Facility | 52 · Reduced service | $380.19 | $380.19 | $380.19 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $151.36 | Facility | 53 · Discontinued | $151.36 | $151.36 | $151.36 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | 56 · Pre-op care only | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $380.19 Median $380.19 Typical High $436.52 | Professional | 52 · Reduced service | $380.19 | $380.19 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $173.78 | Professional | 53 · Discontinued | $151.36 | $151.36 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $87.10 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $87.10 |
BCBS Minnesota Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $1,000.00 Typical High $1,659.59 | Professional | 62 · Two surgeons | $741.31 | $1,000.00 | $1,659.59 |
Where Minnesota sits
The same service costs 7.8 times more in Maine than in Massachusetts. 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 $16,585MA $2,122
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.