How much rates vary
Facilitymedian $2,239 · 10th to 90th $1,072 to $7,586Professionalmedian $2,692 · 10th to 90th $1,413 to $4,786
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 $1,122.02 Median $1,122.02 Typical High $1,122.02 | Facility | None | $1,122.02 | $1,122.02 | $1,122.02 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $851.14 | Facility | 54 · Surgery only | $851.14 | $851.14 | $851.14 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $169.82 | Facility | 55 · Aftercare only | $169.82 | $169.82 | $169.82 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $794.33 | Facility | 78 · Unplanned return to OR | $794.33 | $794.33 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,288.25 | Professional | None | $1,122.02 | $1,122.02 | $1,288.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $954.99 | Professional | 54 · Surgery only | $851.14 | $851.14 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $190.55 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $891.25 |
BCBS Minnesota Setting Facility Modifier None Typical Low $4,365.16 Median $7,762.47 Typical High $14,454.40 | Facility | None | $4,365.16 | $7,762.47 | $14,454.40 |
BCBS Minnesota Setting Professional Modifier None Typical Low $2,089.30 Median $2,691.53 Typical High $4,466.84 | Professional | None | $2,089.30 | $2,691.53 | $4,466.84 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $2,137.96 Typical High $3,548.13 | Professional | 54 · Surgery only | $1,659.59 | $2,137.96 | $3,548.13 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $537.03 Typical High $870.96 | Professional | 55 · Aftercare only | $416.87 | $537.03 | $870.96 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $2,238.72 Typical High $3,715.35 | Professional | 78 · Unplanned return to OR | $1,737.80 | $2,238.72 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $1,862.09 Median $2,951.21 Typical High $5,623.41 | Facility | None | $1,862.09 | $2,951.21 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $3,388.44 Typical High $5,248.07 | Professional | None | $2,187.76 | $3,388.44 | $5,248.07 |
Health Partners Setting Facility Modifier None Typical Low $1,659.59 Median $2,691.53 Typical High $4,677.35 | Facility | None | $1,659.59 | $2,691.53 | $4,677.35 |
Health Partners Setting Professional Modifier None Typical Low $1,905.46 Median $3,019.95 Typical High $4,677.35 | Professional | None | $1,905.46 | $3,019.95 | $4,677.35 |
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 $1,412.54 Median $2,691.53 Typical High $8,912.51 | Professional | None | $1,412.54 | $2,691.53 | $8,912.51 |
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 $1,380.38 Median $2,398.83 Typical High $5,011.87 | Professional | None | $1,380.38 | $2,398.83 | $5,011.87 |
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 $562.34 Median $562.34 Typical High $562.34 | Facility | 52 · Reduced service | $562.34 | $562.34 | $562.34 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $229.09 | Facility | 53 · Discontinued | $229.09 | $229.09 | $229.09 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | 56 · Pre-op care only | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $562.34 Median $562.34 Typical High $645.65 | Professional | 52 · Reduced service | $562.34 | $562.34 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $257.04 | Professional | 53 · Discontinued | $229.09 | $229.09 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $128.82 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $128.82 |
BCBS Minnesota Setting Professional Modifier 62 · Two surgeons Typical Low $1,288.25 Median $1,698.24 Typical High $2,754.23 | Professional | 62 · Two surgeons | $1,288.25 | $1,698.24 | $2,754.23 |
Where Minnesota sits
The same service costs 8.5 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 $16,489MD $1,943
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.