How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,122 to $11,482Professionalmedian $5,623 · 10th to 90th $2,951 to $10,000
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 $2,344.23 Median $2,344.23 Typical High $2,344.23 | Facility | None | $2,344.23 | $2,344.23 | $2,344.23 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Facility | 54 · Surgery only | $1,778.28 | $1,778.28 | $1,778.28 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $354.81 Median $354.81 Typical High $354.81 | Facility | 55 · Aftercare only | $354.81 | $354.81 | $354.81 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Facility | 78 · Unplanned return to OR | $1,659.59 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,630.27 | Professional | None | $2,344.23 | $2,344.23 | $2,630.27 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,778.28 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,778.28 | $1,778.28 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $354.81 Typical High $398.11 | Professional | 55 · Aftercare only | $354.81 | $354.81 | $398.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,659.59 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,659.59 | $1,862.09 |
BCBS Minnesota Setting Facility Modifier None Typical Low $4,168.69 Median $11,481.54 Typical High $23,442.29 | Facility | None | $4,168.69 | $11,481.54 | $23,442.29 |
BCBS Minnesota Setting Professional Modifier None Typical Low $4,265.80 Median $5,623.41 Typical High $9,332.54 | Professional | None | $4,265.80 | $5,623.41 | $9,332.54 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $3,388.44 Median $4,466.84 Typical High $7,413.10 | Professional | 54 · Surgery only | $3,388.44 | $4,466.84 | $7,413.10 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $851.14 Median $1,122.02 Typical High $1,819.70 | Professional | 55 · Aftercare only | $851.14 | $1,122.02 | $1,819.70 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,548.13 Median $4,677.35 Typical High $7,762.47 | Professional | 78 · Unplanned return to OR | $3,548.13 | $4,677.35 | $7,762.47 |
Cigna Setting Facility Modifier None Typical Low $3,890.45 Median $6,025.60 Typical High $11,481.54 | Facility | None | $3,890.45 | $6,025.60 | $11,481.54 |
Cigna Setting Professional Modifier None Typical Low $4,466.84 Median $6,918.31 Typical High $10,964.78 | Professional | None | $4,466.84 | $6,918.31 | $10,964.78 |
Health Partners Setting Facility Modifier None Typical Low $3,467.37 Median $5,623.41 Typical High $9,772.37 | Facility | None | $3,467.37 | $5,623.41 | $9,772.37 |
Health Partners Setting Professional Modifier None Typical Low $3,890.45 Median $6,309.57 Typical High $9,549.93 | Professional | None | $3,890.45 | $6,309.57 | $9,549.93 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,445.44 Typical High $4,677.35 | Facility | None | $758.58 | $1,445.44 | $4,677.35 |
Medica Setting Professional Modifier None Typical Low $2,951.21 Median $5,623.41 Typical High $18,197.01 | Professional | None | $2,951.21 | $5,623.41 | $18,197.01 |
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 $2,951.21 Median $5,011.87 Typical High $10,471.29 | Professional | None | $2,951.21 | $5,011.87 | $10,471.29 |
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 $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | 52 · Reduced service | $1,174.90 | $1,174.90 | $1,174.90 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | 53 · Discontinued | $467.74 | $467.74 | $467.74 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $234.42 Median $234.42 Typical High $234.42 | Facility | 56 · Pre-op care only | $234.42 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1,174.90 Median $1,174.90 Typical High $1,318.26 | Professional | 52 · Reduced service | $1,174.90 | $1,174.90 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $467.74 Typical High $524.81 | Professional | 53 · Discontinued | $467.74 | $467.74 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $234.42 Typical High $263.03 | Professional | 56 · Pre-op care only | $234.42 | $234.42 | $263.03 |
BCBS Minnesota Setting Professional Modifier 62 · Two surgeons Typical Low $2,630.27 Median $3,548.13 Typical High $5,754.40 | Professional | 62 · Two surgeons | $2,630.27 | $3,548.13 | $5,754.40 |
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 $35,907WA $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.