How much rates vary
Facilitymedian $575 · 10th to 90th $110 to $3,981Professionalmedian $257 · 10th to 90th $145 to $490
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 $109.65 Median $144.54 Typical High $4,677.35 | Facility | None | $109.65 | $144.54 | $4,677.35 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $81.28 Median $107.15 Typical High $107.15 | Facility | 54 · Surgery only | $81.28 | $107.15 | $107.15 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.22 Median $21.38 Typical High $21.38 | Facility | 55 · Aftercare only | $16.22 | $21.38 | $21.38 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $100.00 Typical High $100.00 | Facility | 78 · Unplanned return to OR | $75.86 | $100.00 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $138.04 Typical High $173.78 | Professional | None | $109.65 | $138.04 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $91.20 Typical High $107.15 | Professional | 54 · Surgery only | $81.28 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $18.20 Typical High $21.38 | Professional | 55 · Aftercare only | $16.22 | $18.20 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $85.11 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $75.86 | $85.11 | $100.00 |
BCBS Minnesota Setting Facility Modifier None Typical Low $933.25 Median $1,995.26 Typical High $3,235.94 | Facility | None | $933.25 | $1,995.26 | $3,235.94 |
BCBS Minnesota Setting Professional Modifier None Typical Low $173.78 Median $269.15 Typical High $436.52 | Professional | None | $173.78 | $269.15 | $436.52 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $218.78 Typical High $346.74 | Professional | 54 · Surgery only | $138.04 | $218.78 | $346.74 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $53.70 Typical High $83.18 | Professional | 55 · Aftercare only | $35.48 | $53.70 | $83.18 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $229.09 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $144.54 | $229.09 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $371.54 Typical High $707.95 | Facility | None | $239.88 | $371.54 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $309.03 Typical High $562.34 | Professional | None | $186.21 | $309.03 | $562.34 |
Health Partners Setting Facility Modifier None Typical Low $213.80 Median $354.81 Typical High $602.56 | Facility | None | $213.80 | $354.81 | $602.56 |
Health Partners Setting Professional Modifier None Typical Low $181.97 Median $295.12 Typical High $562.34 | Professional | None | $181.97 | $295.12 | $562.34 |
Medica Setting Facility Modifier None Typical Low $194.98 Median $676.08 Typical High $2,570.40 | Facility | None | $194.98 | $676.08 | $2,570.40 |
Medica Setting Professional Modifier None Typical Low $173.78 Median $323.59 Typical High $1,071.52 | Professional | None | $173.78 | $323.59 | $1,071.52 |
United Setting Facility Modifier None Typical Low $549.54 Median $1,000.00 Typical High $3,162.28 | Facility | None | $549.54 | $1,000.00 | $3,162.28 |
United Setting Professional Modifier None Typical Low $125.89 Median $213.80 Typical High $436.52 | Professional | None | $125.89 | $213.80 | $436.52 |
6 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 $53.70 Median $72.44 Typical High $72.44 | Facility | 52 · Reduced service | $53.70 | $72.44 | $72.44 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $21.88 Median $28.84 Typical High $28.84 | Facility | 53 · Discontinued | $21.88 | $28.84 | $28.84 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.96 Median $14.45 Typical High $14.45 | Facility | 56 · Pre-op care only | $10.96 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $53.70 Median $61.66 Typical High $72.44 | Professional | 52 · Reduced service | $53.70 | $61.66 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $24.55 Typical High $28.84 | Professional | 53 · Discontinued | $21.88 | $24.55 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $12.30 Typical High $14.45 | Professional | 56 · Pre-op care only | $10.96 | $12.30 | $14.45 |
Where Minnesota sits
The same service costs 4.1 times more in Alaska 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.
Minnesota· 3rd of 51
$269
AK $437KY $107
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.