How much rates vary
Facilitymedian $4,467 · 10th to 90th $1,349 to $7,413Professionalmedian $1,318 · 10th to 90th $355 to $4,365
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 $1,202.26 Median $4,677.35 Typical High $6,918.31 | Facility | None | $1,202.26 | $4,677.35 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $407.38 Typical High $1,445.44 | Professional | None | $208.93 | $407.38 | $1,445.44 |
BCBS Minnesota Setting Facility Modifier None Typical Low $3,235.94 Median $6,606.93 Typical High $12,022.64 | Facility | None | $3,235.94 | $6,606.93 | $12,022.64 |
BCBS Minnesota Setting Professional Modifier None Typical Low $371.54 Median $1,479.11 Typical High $3,630.78 | Professional | None | $371.54 | $1,479.11 | $3,630.78 |
BCBS Minnesota Setting Professional Modifier 62 · Two surgeons Typical Low $229.09 Median $977.24 Typical High $2,290.87 | Professional | 62 · Two surgeons | $229.09 | $977.24 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $3,311.31 Typical High $6,309.57 | Facility | None | $1,995.26 | $3,311.31 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $1,862.09 Typical High $5,370.32 | Professional | None | $489.78 | $1,862.09 | $5,370.32 |
Health Partners Setting Facility Modifier None Typical Low $1,862.09 Median $3,019.95 Typical High $5,248.07 | Facility | None | $1,862.09 | $3,019.95 | $5,248.07 |
Health Partners Setting Professional Modifier None Typical Low $436.52 Median $1,513.56 Typical High $4,466.84 | Professional | None | $436.52 | $1,513.56 | $4,466.84 |
Medica Setting Facility Modifier None Typical Low $1,148.15 Median $2,454.71 Typical High $6,456.54 | Facility | None | $1,148.15 | $2,454.71 | $6,456.54 |
Medica Setting Professional Modifier None Typical Low $1,584.89 Median $3,715.35 Typical High $7,943.28 | Professional | None | $1,584.89 | $3,715.35 | $7,943.28 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,570.40 Typical High $8,128.31 | Facility | None | $1,513.56 | $2,570.40 | $8,128.31 |
United Setting Professional Modifier None Typical Low $331.13 Median $977.24 Typical High $4,897.79 | Professional | None | $331.13 | $977.24 | $4,897.79 |
10 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 $104.71 Median $602.56 Typical High $602.56 | Facility | 52 · Reduced service | $104.71 | $602.56 | $602.56 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $41.69 Median $239.88 Typical High $239.88 | Facility | 53 · Discontinued | $41.69 | $239.88 | $239.88 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $154.88 Median $912.01 Typical High $912.01 | Facility | 54 · Surgery only | $154.88 | $912.01 | $912.01 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $30.90 Median $181.97 Typical High $181.97 | Facility | 55 · Aftercare only | $30.90 | $181.97 | $181.97 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $20.89 Median $120.23 Typical High $120.23 | Facility | 56 · Pre-op care only | $20.89 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $104.71 Median $229.09 Typical High $602.56 | Professional | 52 · Reduced service | $104.71 | $229.09 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $93.33 Typical High $239.88 | Professional | 53 · Discontinued | $41.69 | $93.33 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $346.74 Typical High $912.01 | Professional | 54 · Surgery only | $154.88 | $346.74 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $69.18 Typical High $181.97 | Professional | 55 · Aftercare only | $30.90 | $69.18 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $45.71 Typical High $120.23 | Professional | 56 · Pre-op care only | $20.89 | $45.71 | $120.23 |
Where Minnesota sits
The same service costs 4.3 times more in Vermont than in Maine. 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
VT $8,043ME $1,891
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.