How much rates vary
Facilitymedian $1,862 · 10th to 90th $891 to $8,511Professionalmedian $2,089 · 10th to 90th $1,148 to $3,890
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 $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | 54 · Surgery only | $676.08 | $676.08 | $676.08 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | 55 · Aftercare only | $134.90 | $134.90 | $134.90 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | 78 · Unplanned return to OR | $630.96 | $630.96 | $630.96 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,071.52 | Professional | None | $891.25 | $891.25 | $1,071.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $758.58 | Professional | 54 · Surgery only | $676.08 | $676.08 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $151.36 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $707.95 |
BCBS Minnesota Setting Facility Modifier None Typical Low $5,495.41 Median $11,481.54 Typical High $23,988.33 | Facility | None | $5,495.41 | $11,481.54 | $23,988.33 |
BCBS Minnesota Setting Professional Modifier None Typical Low $1,659.59 Median $2,089.30 Typical High $3,467.37 | Professional | None | $1,659.59 | $2,089.30 | $3,467.37 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,698.24 Typical High $2,754.23 | Professional | 54 · Surgery only | $1,318.26 | $1,698.24 | $2,754.23 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $426.58 Typical High $691.83 | Professional | 55 · Aftercare only | $331.13 | $426.58 | $691.83 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,778.28 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,778.28 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $2,290.87 Typical High $4,365.16 | Facility | None | $1,479.11 | $2,290.87 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $2,691.53 Typical High $4,168.69 | Professional | None | $1,737.80 | $2,691.53 | $4,168.69 |
Health Partners Setting Facility Modifier None Typical Low $1,318.26 Median $2,137.96 Typical High $3,715.35 | Facility | None | $1,318.26 | $2,137.96 | $3,715.35 |
Health Partners Setting Professional Modifier None Typical Low $1,513.56 Median $2,398.83 Typical High $3,630.78 | Professional | None | $1,513.56 | $2,398.83 | $3,630.78 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,412.54 Typical High $3,019.95 | Facility | None | $758.58 | $1,412.54 | $3,019.95 |
Medica Setting Professional Modifier None Typical Low $1,148.15 Median $2,137.96 Typical High $12,302.69 | Professional | None | $1,148.15 | $2,137.96 | $12,302.69 |
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 $1,122.02 Median $1,949.84 Typical High $3,981.07 | Professional | None | $1,122.02 | $1,949.84 | $3,981.07 |
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 $446.68 Median $446.68 Typical High $446.68 | Facility | 52 · Reduced service | $446.68 | $446.68 | $446.68 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $177.83 | Facility | 53 · Discontinued | $177.83 | $177.83 | $177.83 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | 56 · Pre-op care only | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $446.68 Median $446.68 Typical High $501.19 | Professional | 52 · Reduced service | $446.68 | $446.68 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $199.53 | Professional | 53 · Discontinued | $177.83 | $177.83 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $100.00 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $100.00 |
BCBS Minnesota Setting Professional Modifier 62 · Two surgeons Typical Low $1,023.29 Median $1,318.26 Typical High $2,137.96 | Professional | 62 · Two surgeons | $1,023.29 | $1,318.26 | $2,137.96 |
Where Minnesota sits
The same service costs 9.8 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 $16,204MD $1,659
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.