How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,122 to $10,965Professionalmedian $5,888 · 10th to 90th $2,818 to $11,220
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 $2,630.27 Median $2,630.27 Typical High $2,630.27 | Facility | None | $2,630.27 | $2,630.27 | $2,630.27 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Facility | 54 · Surgery only | $1,995.26 | $1,995.26 | $1,995.26 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | 55 · Aftercare only | $398.11 | $398.11 | $398.11 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Facility | 78 · Unplanned return to OR | $1,862.09 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,884.03 | Professional | None | $2,630.27 | $2,630.27 | $2,884.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $1,995.26 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,995.26 | $1,995.26 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $398.11 Median $398.11 Typical High $436.52 | Professional | 55 · Aftercare only | $398.11 | $398.11 | $436.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $1,862.09 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,862.09 | $1,862.09 | $2,041.74 |
BCBS Minnesota Setting Facility Modifier None Typical Low $2,238.72 Median $6,025.60 Typical High $21,379.62 | Facility | None | $2,238.72 | $6,025.60 | $21,379.62 |
BCBS Minnesota Setting Professional Modifier None Typical Low $3,981.07 Median $5,370.32 Typical High $9,549.93 | Professional | None | $3,981.07 | $5,370.32 | $9,549.93 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $3,235.94 Median $4,365.16 Typical High $7,762.47 | Professional | 54 · Surgery only | $3,235.94 | $4,365.16 | $7,762.47 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $794.33 Median $1,096.48 Typical High $1,905.46 | Professional | 55 · Aftercare only | $794.33 | $1,096.48 | $1,905.46 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,388.44 Median $4,570.88 Typical High $8,128.31 | Professional | 78 · Unplanned return to OR | $3,388.44 | $4,570.88 | $8,128.31 |
Cigna Setting Facility Modifier None Typical Low $4,365.16 Median $6,760.83 Typical High $12,882.50 | Facility | None | $4,365.16 | $6,760.83 | $12,882.50 |
Cigna Setting Professional Modifier None Typical Low $5,128.61 Median $7,762.47 Typical High $12,302.69 | Professional | None | $5,128.61 | $7,762.47 | $12,302.69 |
Health Partners Setting Facility Modifier None Typical Low $3,890.45 Median $6,309.57 Typical High $10,964.78 | Facility | None | $3,890.45 | $6,309.57 | $10,964.78 |
Health Partners Setting Professional Modifier None Typical Low $4,365.16 Median $7,079.46 Typical High $10,715.19 | Professional | None | $4,365.16 | $7,079.46 | $10,715.19 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,445.44 Typical High $5,248.07 | Facility | None | $758.58 | $1,445.44 | $5,248.07 |
Medica Setting Professional Modifier None Typical Low $3,019.95 Median $5,888.44 Typical High $19,952.62 | Professional | None | $3,019.95 | $5,888.44 | $19,952.62 |
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 $3,019.95 Median $5,495.41 Typical High $11,220.18 | Professional | None | $3,019.95 | $5,495.41 | $11,220.18 |
9 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 $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | 52 · Reduced service | $1,318.26 | $1,318.26 | $1,318.26 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $524.81 Median $524.81 Typical High $524.81 | Facility | 53 · Discontinued | $524.81 | $524.81 | $524.81 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | 56 · Pre-op care only | $263.03 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1,318.26 Median $1,318.26 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,318.26 | $1,318.26 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $524.81 Typical High $575.44 | Professional | 53 · Discontinued | $524.81 | $524.81 | $575.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $263.03 Median $263.03 Typical High $288.40 | Professional | 56 · Pre-op care only | $263.03 | $263.03 | $288.40 |
BCBS Minnesota Setting Facility Modifier 50 · Both sides Typical Low $3,311.31 Median $6,165.95 Typical High $11,481.54 | Facility | 50 · Both sides | $3,311.31 | $6,165.95 | $11,481.54 |
BCBS Minnesota Setting Professional Modifier 50 · Both sides Typical Low $6,025.60 Median $8,128.31 Typical High $14,454.40 | Professional | 50 · Both sides | $6,025.60 | $8,128.31 | $14,454.40 |
BCBS Minnesota Setting Professional Modifier 62 · Two surgeons Typical Low $2,511.89 Median $3,388.44 Typical High $5,888.44 | Professional | 62 · Two surgeons | $2,511.89 | $3,388.44 | $5,888.44 |
Where Minnesota sits
The same service costs 12.3 times more in Maine than in Washington. 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 $36,075WA $2,929
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.