How much rates vary
Facilitymedian $2,951 · 10th to 90th $1,230 to $8,913Professionalmedian $2,239 · 10th to 90th $1,230 to $4,365
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 $1,230.27 | Facility | None | $1,230.27 | $1,230.27 | $1,230.27 |
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 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 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 $1,348.96 | Professional | None | $1,230.27 | $1,230.27 | $1,348.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $1,023.29 | Professional | 54 · Surgery only | $912.01 | $912.01 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $204.17 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $954.99 |
BCBS Minnesota Setting Facility Modifier None Typical Low $3,235.94 Median $6,456.54 Typical High $14,125.38 | Facility | None | $3,235.94 | $6,456.54 | $14,125.38 |
BCBS Minnesota Setting Professional Modifier None Typical Low $1,659.59 Median $2,089.30 Typical High $3,801.89 | Professional | None | $1,659.59 | $2,089.30 | $3,801.89 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,698.24 Typical High $3,019.95 | Professional | 54 · Surgery only | $1,318.26 | $1,698.24 | $3,019.95 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $416.87 Typical High $724.44 | Professional | 55 · Aftercare only | $331.13 | $416.87 | $724.44 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,778.28 Typical High $3,162.28 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,778.28 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $1,905.46 Median $2,951.21 Typical High $5,623.41 | Facility | None | $1,905.46 | $2,951.21 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $2,951.21 Typical High $4,786.30 | Professional | None | $1,905.46 | $2,951.21 | $4,786.30 |
Health Partners Setting Facility Modifier None Typical Low $1,659.59 Median $2,691.53 Typical High $4,677.35 | Facility | None | $1,659.59 | $2,691.53 | $4,677.35 |
Health Partners Setting Professional Modifier None Typical Low $1,659.59 Median $2,691.53 Typical High $4,570.88 | Professional | None | $1,659.59 | $2,691.53 | $4,570.88 |
Medica Setting Facility Modifier None Typical Low $1,995.26 Median $2,884.03 Typical High $7,762.47 | Facility | None | $1,995.26 | $2,884.03 | $7,762.47 |
Medica Setting Professional Modifier None Typical Low $1,258.93 Median $2,187.76 Typical High $8,511.38 | Professional | None | $1,258.93 | $2,187.76 | $8,511.38 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $3,467.37 Typical High $10,000.00 | Facility | None | $1,995.26 | $3,467.37 | $10,000.00 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $2,041.74 Typical High $4,073.80 | Professional | None | $1,202.26 | $2,041.74 | $4,073.80 |
9 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 $602.56 Median $602.56 Typical High $602.56 | Facility | 52 · Reduced service | $602.56 | $602.56 | $602.56 |
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 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 $602.56 Median $602.56 Typical High $676.08 | Professional | 52 · Reduced service | $602.56 | $602.56 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $269.15 | Professional | 53 · Discontinued | $245.47 | $245.47 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $134.90 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $134.90 |
BCBS Minnesota Setting Facility Modifier 50 · Both sides Typical Low $7,413.10 Median $14,125.38 Typical High $25,118.86 | Facility | 50 · Both sides | $7,413.10 | $14,125.38 | $25,118.86 |
BCBS Minnesota Setting Professional Modifier 50 · Both sides Typical Low $2,454.71 Median $3,162.28 Typical High $5,754.40 | Professional | 50 · Both sides | $2,454.71 | $3,162.28 | $5,754.40 |
BCBS Minnesota Setting Professional Modifier 62 · Two surgeons Typical Low $1,023.29 Median $1,318.26 Typical High $2,290.87 | Professional | 62 · Two surgeons | $1,023.29 | $1,318.26 | $2,290.87 |
Where Minnesota sits
The same service costs 3.8 times more in Wisconsin than in Delaware. 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
WI $11,217DE $2,968
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.