How much rates vary
Facilitymedian $2,630 · 10th to 90th $1,122 to $8,913Professionalmedian $3,311 · 10th to 90th $1,738 to $5,888
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 $1,380.38 Median $1,380.38 Typical High $1,380.38 | Facility | None | $1,380.38 | $1,380.38 | $1,380.38 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Facility | 54 · Surgery only | $1,047.13 | $1,047.13 | $1,047.13 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | 55 · Aftercare only | $208.93 | $208.93 | $208.93 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $977.24 | Facility | 78 · Unplanned return to OR | $977.24 | $977.24 | $977.24 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,621.81 | Professional | None | $1,380.38 | $1,380.38 | $1,621.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $234.42 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $1,096.48 |
BCBS Minnesota Setting Facility Modifier None Typical Low $4,365.16 Median $9,120.11 Typical High $16,595.87 | Facility | None | $4,365.16 | $9,120.11 | $16,595.87 |
BCBS Minnesota Setting Professional Modifier None Typical Low $2,570.40 Median $3,311.31 Typical High $5,495.41 | Professional | None | $2,570.40 | $3,311.31 | $5,495.41 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,630.27 Typical High $4,365.16 | Professional | 54 · Surgery only | $2,041.74 | $2,630.27 | $4,365.16 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $512.86 Median $660.69 Typical High $1,071.52 | Professional | 55 · Aftercare only | $512.86 | $660.69 | $1,071.52 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,137.96 Median $2,754.23 Typical High $4,570.88 | Professional | 78 · Unplanned return to OR | $2,137.96 | $2,754.23 | $4,570.88 |
Cigna Setting Facility Modifier None Typical Low $2,290.87 Median $3,548.13 Typical High $6,918.31 | Facility | None | $2,290.87 | $3,548.13 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $2,691.53 Median $4,168.69 Typical High $6,456.54 | Professional | None | $2,691.53 | $4,168.69 | $6,456.54 |
Health Partners Setting Facility Modifier None Typical Low $2,041.74 Median $3,311.31 Typical High $5,754.40 | Facility | None | $2,041.74 | $3,311.31 | $5,754.40 |
Health Partners Setting Professional Modifier None Typical Low $2,344.23 Median $3,715.35 Typical High $5,754.40 | Professional | None | $2,344.23 | $3,715.35 | $5,754.40 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,445.44 Typical High $3,467.37 | Facility | None | $758.58 | $1,445.44 | $3,467.37 |
Medica Setting Professional Modifier None Typical Low $1,737.80 Median $3,311.31 Typical High $10,964.78 | Professional | None | $1,737.80 | $3,311.31 | $10,964.78 |
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 $1,698.24 Median $2,884.03 Typical High $6,025.60 | Professional | None | $1,698.24 | $2,884.03 | $6,025.60 |
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 $691.83 Median $691.83 Typical High $691.83 | Facility | 52 · Reduced service | $691.83 | $691.83 | $691.83 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $281.84 | Facility | 53 · Discontinued | $281.84 | $281.84 | $281.84 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | 56 · Pre-op care only | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $691.83 Median $691.83 Typical High $776.25 | Professional | 52 · Reduced service | $691.83 | $691.83 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $316.23 | Professional | 53 · Discontinued | $281.84 | $281.84 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $154.88 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $154.88 |
BCBS Minnesota Setting Professional Modifier 62 · Two surgeons Typical Low $1,584.89 Median $2,089.30 Typical High $3,311.31 | Professional | 62 · Two surgeons | $1,584.89 | $2,089.30 | $3,311.31 |
Where Minnesota sits
The same service costs 15.5 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 $34,449MD $2,222
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.