How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,148 to $18,621Professionalmedian $4,571 · 10th to 90th $2,188 to $8,318
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 $2,137.96 Median $2,137.96 Typical High $2,137.96 | Facility | None | $2,137.96 | $2,137.96 | $2,137.96 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Facility | 54 · Surgery only | $1,584.89 | $1,584.89 | $1,584.89 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $316.23 Median $316.23 Typical High $316.23 | Facility | 55 · Aftercare only | $316.23 | $316.23 | $316.23 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Facility | 78 · Unplanned return to OR | $1,479.11 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,344.23 | Professional | None | $2,137.96 | $2,137.96 | $2,344.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,584.89 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,584.89 | $1,584.89 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $316.23 Typical High $346.74 | Professional | 55 · Aftercare only | $316.23 | $316.23 | $346.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,479.11 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,479.11 | $1,621.81 |
BCBS Minnesota Setting Facility Modifier None Typical Low $12,302.69 Median $32,359.37 Typical High $69,183.10 | Facility | None | $12,302.69 | $32,359.37 | $69,183.10 |
BCBS Minnesota Setting Professional Modifier None Typical Low $3,715.35 Median $4,897.79 Typical High $7,585.78 | Professional | None | $3,715.35 | $4,897.79 | $7,585.78 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $2,951.21 Median $3,890.45 Typical High $6,025.60 | Professional | 54 · Surgery only | $2,951.21 | $3,890.45 | $6,025.60 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $741.31 Median $977.24 Typical High $1,479.11 | Professional | 55 · Aftercare only | $741.31 | $977.24 | $1,479.11 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,090.30 Median $4,073.80 Typical High $6,309.57 | Professional | 78 · Unplanned return to OR | $3,090.30 | $4,073.80 | $6,309.57 |
Cigna Setting Facility Modifier None Typical Low $3,548.13 Median $5,495.41 Typical High $10,471.29 | Facility | None | $3,548.13 | $5,495.41 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $3,388.44 Median $5,754.40 Typical High $8,912.51 | Professional | None | $3,388.44 | $5,754.40 | $8,912.51 |
Health Partners Setting Facility Modifier None Typical Low $3,162.28 Median $5,011.87 Typical High $8,709.64 | Facility | None | $3,162.28 | $5,011.87 | $8,709.64 |
Health Partners Setting Professional Modifier None Typical Low $3,019.95 Median $5,248.07 Typical High $8,511.38 | Professional | None | $3,019.95 | $5,248.07 | $8,511.38 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,513.56 Typical High $4,570.88 | Facility | None | $758.58 | $1,513.56 | $4,570.88 |
Medica Setting Professional Modifier None Typical Low $2,454.71 Median $4,365.16 Typical High $16,218.10 | Professional | None | $2,454.71 | $4,365.16 | $16,218.10 |
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 $2,290.87 Median $3,981.07 Typical High $8,317.64 | Professional | None | $2,290.87 | $3,981.07 | $8,317.64 |
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 $1,071.52 Median $1,071.52 Typical High $1,071.52 | Facility | 52 · Reduced service | $1,071.52 | $1,071.52 | $1,071.52 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $426.58 Median $426.58 Typical High $426.58 | Facility | 53 · Discontinued | $426.58 | $426.58 | $426.58 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | 56 · Pre-op care only | $213.80 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1,071.52 Median $1,071.52 Typical High $1,148.15 | Professional | 52 · Reduced service | $1,071.52 | $1,071.52 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $426.58 Typical High $457.09 | Professional | 53 · Discontinued | $426.58 | $426.58 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $213.80 Typical High $229.09 | Professional | 56 · Pre-op care only | $213.80 | $213.80 | $229.09 |
BCBS Minnesota Setting Professional Modifier 62 · Two surgeons Typical Low $2,290.87 Median $3,090.30 Typical High $4,570.88 | Professional | 62 · Two surgeons | $2,290.87 | $3,090.30 | $4,570.88 |
Where Minnesota sits
The same service costs 13.8 times more in Maine than in Texas. 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 $35,114TX $2,545
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.