How much rates vary
Facilitymedian $2,239 · 10th to 90th $871 to $7,943Professionalmedian $1,514 · 10th to 90th $871 to $3,090
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 $870.96 Median $870.96 Typical High $870.96 | Facility | None | $870.96 | $870.96 | $870.96 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $645.65 | Facility | 54 · Surgery only | $645.65 | $645.65 | $645.65 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $602.56 | Facility | 78 · Unplanned return to OR | $602.56 | $602.56 | $602.56 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $870.96 Typical High $1,096.48 | Professional | None | $812.83 | $870.96 | $1,096.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $724.44 | Professional | 54 · Surgery only | $645.65 | $645.65 | $724.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $676.08 |
BCBS Minnesota Setting Facility Modifier None Typical Low $4,073.80 Median $7,244.36 Typical High $14,454.40 | Facility | None | $4,073.80 | $7,244.36 | $14,454.40 |
BCBS Minnesota Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $2,691.53 | Professional | None | $1,202.26 | $1,513.56 | $2,691.53 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,202.26 Typical High $2,137.96 | Professional | 54 · Surgery only | $954.99 | $1,202.26 | $2,137.96 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,288.25 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,288.25 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $2,089.30 Typical High $3,981.07 | Facility | None | $1,348.96 | $2,089.30 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $2,041.74 Typical High $3,388.44 | Professional | None | $1,174.90 | $2,041.74 | $3,388.44 |
Health Partners Setting Facility Modifier None Typical Low $1,202.26 Median $1,905.46 Typical High $3,311.31 | Facility | None | $1,202.26 | $1,905.46 | $3,311.31 |
Health Partners Setting Professional Modifier None Typical Low $1,174.90 Median $1,905.46 Typical High $3,235.94 | Professional | None | $1,174.90 | $1,905.46 | $3,235.94 |
Medica Setting Facility Modifier None Typical Low $1,412.54 Median $2,754.23 Typical High $7,762.47 | Facility | None | $1,412.54 | $2,754.23 | $7,762.47 |
Medica Setting Professional Modifier None Typical Low $870.96 Median $1,445.44 Typical High $7,943.28 | Professional | None | $870.96 | $1,445.44 | $7,943.28 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $3,090.30 Typical High $10,000.00 | Facility | None | $1,995.26 | $3,090.30 | $10,000.00 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,380.38 Typical High $2,754.23 | Professional | None | $812.83 | $1,380.38 | $2,754.23 |
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 $426.58 Median $426.58 Typical High $426.58 | Facility | 52 · Reduced service | $426.58 | $426.58 | $426.58 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | 53 · Discontinued | $173.78 | $173.78 | $173.78 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | 55 · Aftercare only | $128.82 | $128.82 | $128.82 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | 56 · Pre-op care only | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $426.58 Median $426.58 Typical High $478.63 | Professional | 52 · Reduced service | $426.58 | $426.58 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $190.55 | Professional | 53 · Discontinued | $173.78 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $144.54 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $95.50 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $95.50 |
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 $1,778.28 Median $2,290.87 Typical High $3,981.07 | Professional | 50 · Both sides | $1,778.28 | $2,290.87 | $3,981.07 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $302.00 Typical High $512.86 | Professional | 55 · Aftercare only | $239.88 | $302.00 | $512.86 |
BCBS Minnesota Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $954.99 Typical High $1,621.81 | Professional | 62 · Two surgeons | $741.31 | $954.99 | $1,621.81 |
Where Minnesota sits
The same service costs 3.6 times more in Vermont than in Montana. 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
VT $8,561MT $2,405
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.