How much rates vary
Facilitymedian $2,818 · 10th to 90th $851 to $11,482Professionalmedian $1,862 · 10th to 90th $851 to $3,236
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 $851.14 Median $851.14 Typical High $851.14 | Facility | None | $851.14 | $851.14 | $851.14 |
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 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 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 $851.14 Median $851.14 Typical High $912.01 | Professional | None | $851.14 | $851.14 | $912.01 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $676.08 | Professional | 54 · Surgery only | $645.65 | $645.65 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $134.90 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $630.96 |
BCBS Minnesota Setting Facility Modifier None Typical Low $2,041.74 Median $11,748.98 Typical High $26,915.35 | Facility | None | $2,041.74 | $11,748.98 | $26,915.35 |
BCBS Minnesota Setting Professional Modifier None Typical Low $1,479.11 Median $1,949.84 Typical High $3,019.95 | Professional | None | $1,479.11 | $1,949.84 | $3,019.95 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,548.82 Typical High $2,344.23 | Professional | 54 · Surgery only | $1,174.90 | $1,548.82 | $2,344.23 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $389.05 Typical High $588.84 | Professional | 55 · Aftercare only | $295.12 | $389.05 | $588.84 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,621.81 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,621.81 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $2,187.76 Typical High $4,168.69 | Facility | None | $1,412.54 | $2,187.76 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $2,290.87 Typical High $3,630.78 | Professional | None | $1,348.96 | $2,290.87 | $3,630.78 |
Health Partners Setting Facility Modifier None Typical Low $1,258.93 Median $2,041.74 Typical High $3,548.13 | Facility | None | $1,258.93 | $2,041.74 | $3,548.13 |
Health Partners Setting Professional Modifier None Typical Low $1,202.26 Median $2,137.96 Typical High $3,388.44 | Professional | None | $1,202.26 | $2,137.96 | $3,388.44 |
Medica Setting Facility Modifier None Typical Low $1,513.56 Median $4,365.16 Typical High $9,332.54 | Facility | None | $1,513.56 | $4,365.16 | $9,332.54 |
Medica Setting Professional Modifier None Typical Low $912.01 Median $1,659.59 Typical High $6,456.54 | Professional | None | $912.01 | $1,659.59 | $6,456.54 |
United Setting Facility Modifier None Typical Low $3,235.94 Median $5,370.32 Typical High $12,882.50 | Facility | None | $3,235.94 | $5,370.32 | $12,882.50 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,548.82 Typical High $3,162.28 | Professional | None | $870.96 | $1,548.82 | $3,162.28 |
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 $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 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | 56 · Pre-op care only | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $426.58 Median $426.58 Typical High $446.68 | Professional | 52 · Reduced service | $426.58 | $426.58 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $177.83 | Professional | 53 · Discontinued | $173.78 | $173.78 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $89.13 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $89.13 |
BCBS Minnesota Setting Professional Modifier 62 · Two surgeons Typical Low $912.01 Median $1,202.26 Typical High $1,819.70 | Professional | 62 · Two surgeons | $912.01 | $1,202.26 | $1,819.70 |
Where Minnesota sits
The same service costs 5.1 times more in Oklahoma 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.
Physician feeFacility fee
OK $11,738KY $2,311
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.