How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,230 to $12,023Professionalmedian $2,630 · 10th to 90th $1,230 to $4,898
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 $1,230.27 Median $1,230.27 Typical High $10,715.19 | Facility | None | $1,230.27 | $1,230.27 | $10,715.19 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $912.01 | Facility | 54 · Surgery only | $912.01 | $912.01 | $912.01 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $851.14 | Facility | 78 · Unplanned return to OR | $851.14 | $851.14 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,698.24 | Professional | None | $1,230.27 | $1,230.27 | $1,698.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $977.24 | Professional | 54 · Surgery only | $912.01 | $912.01 | $977.24 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $912.01 |
BCBS Minnesota Setting Facility Modifier None Typical Low $7,585.78 Median $12,882.50 Typical High $26,915.35 | Facility | None | $7,585.78 | $12,882.50 | $26,915.35 |
BCBS Minnesota Setting Professional Modifier None Typical Low $2,089.30 Median $2,818.38 Typical High $4,466.84 | Professional | None | $2,089.30 | $2,818.38 | $4,466.84 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $2,238.72 Typical High $3,548.13 | Professional | 54 · Surgery only | $1,659.59 | $2,238.72 | $3,548.13 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $2,344.23 Typical High $3,801.89 | Professional | 78 · Unplanned return to OR | $1,737.80 | $2,344.23 | $3,801.89 |
Cigna Setting Facility Modifier None Typical Low $2,089.30 Median $3,235.94 Typical High $6,025.60 | Facility | None | $2,089.30 | $3,235.94 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $1,949.84 Median $3,311.31 Typical High $5,128.61 | Professional | None | $1,949.84 | $3,311.31 | $5,128.61 |
Health Partners Setting Facility Modifier None Typical Low $1,819.70 Median $2,951.21 Typical High $5,248.07 | Facility | None | $1,819.70 | $2,951.21 | $5,248.07 |
Health Partners Setting Professional Modifier None Typical Low $1,737.80 Median $3,019.95 Typical High $4,897.79 | Professional | None | $1,737.80 | $3,019.95 | $4,897.79 |
Medica Setting Facility Modifier None Typical Low $2,137.96 Median $4,897.79 Typical High $11,220.18 | Facility | None | $2,137.96 | $4,897.79 | $11,220.18 |
Medica Setting Professional Modifier None Typical Low $1,412.54 Median $2,570.40 Typical High $10,471.29 | Professional | None | $1,412.54 | $2,570.40 | $10,471.29 |
United Setting Facility Modifier None Typical Low $3,235.94 Median $5,370.32 Typical High $12,882.50 | Facility | None | $3,235.94 | $5,370.32 | $12,882.50 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $2,290.87 Typical High $4,677.35 | Professional | None | $1,318.26 | $2,290.87 | $4,677.35 |
12 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 $616.60 Median $616.60 Typical High $616.60 | Facility | 52 · Reduced service | $616.60 | $616.60 | $616.60 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | 53 · Discontinued | $245.47 | $245.47 | $245.47 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $181.97 | Facility | 55 · Aftercare only | $181.97 | $181.97 | $181.97 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | 56 · Pre-op care only | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $616.60 Median $616.60 Typical High $645.65 | Professional | 52 · Reduced service | $616.60 | $616.60 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $257.04 | Professional | 53 · Discontinued | $245.47 | $245.47 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $194.98 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $128.82 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $128.82 |
BCBS Minnesota Setting Facility Modifier 50 · Both sides Typical Low $14,125.38 Median $26,302.68 Typical High $47,863.01 | Facility | 50 · Both sides | $14,125.38 | $26,302.68 | $47,863.01 |
BCBS Minnesota Setting Professional Modifier 50 · Both sides Typical Low $3,090.30 Median $4,168.69 Typical High $6,760.83 | Professional | 50 · Both sides | $3,090.30 | $4,168.69 | $6,760.83 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $562.34 Typical High $891.25 | Professional | 55 · Aftercare only | $416.87 | $562.34 | $891.25 |
BCBS Minnesota Setting Professional Modifier 62 · Two surgeons Typical Low $1,288.25 Median $1,737.80 Typical High $2,691.53 | Professional | 62 · Two surgeons | $1,288.25 | $1,737.80 | $2,691.53 |
Where Minnesota sits
The same service costs 4.7 times more in Colorado than in Kentucky. 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
CO $15,002KY $3,224
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.