How much rates vary
Facilitymedian $1,585 · 10th to 90th $398 to $6,457Professionalmedian $1,096 · 10th to 90th $501 to $1,950
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 $398.11 Median $501.19 Typical High $6,456.54 | Facility | None | $398.11 | $501.19 | $6,456.54 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $302.00 Median $380.19 Typical High $380.19 | Facility | 54 · Surgery only | $302.00 | $380.19 | $380.19 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $60.26 Median $75.86 Typical High $75.86 | Facility | 55 · Aftercare only | $60.26 | $75.86 | $75.86 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $354.81 Typical High $354.81 | Facility | 78 · Unplanned return to OR | $281.84 | $354.81 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $457.09 Typical High $588.84 | Professional | None | $398.11 | $457.09 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $323.59 Typical High $380.19 | Professional | 54 · Surgery only | $302.00 | $323.59 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $64.57 Typical High $75.86 | Professional | 55 · Aftercare only | $60.26 | $64.57 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $302.00 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $281.84 | $302.00 | $354.81 |
BCBS Minnesota Setting Facility Modifier None Typical Low $2,951.21 Median $7,244.36 Typical High $14,454.40 | Facility | None | $2,951.21 | $7,244.36 | $14,454.40 |
BCBS Minnesota Setting Facility Modifier 50 · Both sides Typical Low $7,585.78 Median $13,803.84 Typical High $25,703.96 | Facility | 50 · Both sides | $7,585.78 | $13,803.84 | $25,703.96 |
BCBS Minnesota Setting Professional Modifier None Typical Low $691.83 Median $1,148.15 Typical High $1,778.28 | Professional | None | $691.83 | $1,148.15 | $1,778.28 |
BCBS Minnesota Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $1,698.24 Typical High $2,630.27 | Professional | 50 · Both sides | $1,047.13 | $1,698.24 | $2,630.27 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $912.01 Typical High $1,412.54 | Professional | 54 · Surgery only | $549.54 | $912.01 | $1,412.54 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $234.42 Typical High $338.84 | Professional | 55 · Aftercare only | $147.91 | $234.42 | $338.84 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $954.99 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $575.44 | $954.99 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,318.26 Typical High $2,511.89 | Facility | None | $851.14 | $1,318.26 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,380.38 Typical High $2,238.72 | Professional | None | $851.14 | $1,380.38 | $2,238.72 |
Health Partners Setting Facility Modifier None Typical Low $741.31 Median $1,230.27 Typical High $2,089.30 | Facility | None | $741.31 | $1,230.27 | $2,089.30 |
Health Partners Setting Professional Modifier None Typical Low $741.31 Median $1,202.26 Typical High $2,041.74 | Professional | None | $741.31 | $1,202.26 | $2,041.74 |
Medica Setting Facility Modifier None Typical Low $707.95 Median $2,041.74 Typical High $6,760.83 | Facility | None | $707.95 | $2,041.74 | $6,760.83 |
Medica Setting Professional Modifier None Typical Low $575.44 Median $1,318.26 Typical High $3,090.30 | Professional | None | $575.44 | $1,318.26 | $3,090.30 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,511.89 Typical High $8,317.64 | Facility | None | $1,513.56 | $2,511.89 | $8,317.64 |
United Setting Professional Modifier None Typical Low $501.19 Median $912.01 Typical High $1,819.70 | Professional | None | $501.19 | $912.01 | $1,819.70 |
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 $199.53 Median $251.19 Typical High $251.19 | Facility | 52 · Reduced service | $199.53 | $251.19 | $251.19 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $79.43 Median $100.00 Typical High $100.00 | Facility | 53 · Discontinued | $79.43 | $100.00 | $100.00 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $39.81 Median $50.12 Typical High $50.12 | Facility | 56 · Pre-op care only | $39.81 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $199.53 Median $218.78 Typical High $251.19 | Professional | 52 · Reduced service | $199.53 | $218.78 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $87.10 Typical High $100.00 | Professional | 53 · Discontinued | $79.43 | $87.10 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $43.65 Typical High $50.12 | Professional | 56 · Pre-op care only | $39.81 | $43.65 | $50.12 |
Where Minnesota sits
The same service costs 7.2 times more in Vermont than in Maine. 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 $9,370ME $1,294
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.