How much rates vary
Facilitymedian $5,623 · 10th to 90th $457 to $19,498Professionalmedian $5,623 · 10th to 90th $708 to $17,783
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 $457.09 Median $1,819.70 Typical High $5,623.41 | Facility | None | $457.09 | $1,819.70 | $5,623.41 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $346.74 Median $4,168.69 Typical High $4,168.69 | Facility | 54 · Surgery only | $346.74 | $4,168.69 | $4,168.69 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $69.18 Median $831.76 Typical High $831.76 | Facility | 55 · Aftercare only | $69.18 | $831.76 | $831.76 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $3,890.45 Typical High $3,890.45 | Facility | 78 · Unplanned return to OR | $323.59 | $3,890.45 | $3,890.45 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $5,248.07 Typical High $5,623.41 | Professional | None | $457.09 | $5,248.07 | $5,623.41 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $3,981.07 Typical High $4,168.69 | Professional | 54 · Surgery only | $346.74 | $3,981.07 | $4,168.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $794.33 Typical High $831.76 | Professional | 55 · Aftercare only | $69.18 | $794.33 | $831.76 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $3,715.35 Typical High $3,890.45 | Professional | 78 · Unplanned return to OR | $323.59 | $3,715.35 | $3,890.45 |
BCBS Minnesota Setting Facility Modifier None Typical Low $2,818.38 Median $11,748.98 Typical High $26,915.35 | Facility | None | $2,818.38 | $11,748.98 | $26,915.35 |
BCBS Minnesota Setting Professional Modifier None Typical Low $758.58 Median $3,467.37 Typical High $14,791.08 | Professional | None | $758.58 | $3,467.37 | $14,791.08 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $2,398.83 Typical High $11,748.98 | Professional | 54 · Surgery only | $616.60 | $2,398.83 | $11,748.98 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $912.01 Typical High $2,951.21 | Professional | 55 · Aftercare only | $154.88 | $912.01 | $2,951.21 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $2,884.03 Typical High $12,302.69 | Professional | 78 · Unplanned return to OR | $645.65 | $2,884.03 | $12,302.69 |
Cigna Setting Facility Modifier None Typical Low $8,511.38 Median $14,125.38 Typical High $26,915.35 | Facility | None | $8,511.38 | $14,125.38 | $26,915.35 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $6,918.31 Typical High $19,498.45 | Professional | None | $812.83 | $6,918.31 | $19,498.45 |
Health Partners Setting Facility Modifier None Typical Low $8,128.31 Median $13,182.57 Typical High $22,908.68 | Facility | None | $8,128.31 | $13,182.57 | $22,908.68 |
Health Partners Setting Professional Modifier None Typical Low $758.58 Median $6,918.31 Typical High $18,197.01 | Professional | None | $758.58 | $6,918.31 | $18,197.01 |
Medica Setting Facility Modifier None Typical Low $870.96 Median $5,011.87 Typical High $12,022.64 | Facility | None | $870.96 | $5,011.87 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $7,413.10 Median $15,488.17 Typical High $52,480.75 | Professional | None | $7,413.10 | $15,488.17 | $52,480.75 |
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 $588.84 Median $3,311.31 Typical High $20,417.38 | Professional | None | $588.84 | $3,311.31 | $20,417.38 |
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 $229.09 Median $2,818.38 Typical High $2,818.38 | Facility | 52 · Reduced service | $229.09 | $2,818.38 | $2,818.38 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $91.20 Median $1,122.02 Typical High $1,122.02 | Facility | 53 · Discontinued | $91.20 | $1,122.02 | $1,122.02 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $45.71 Median $562.34 Typical High $562.34 | Facility | 56 · Pre-op care only | $45.71 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $229.09 Median $2,630.27 Typical High $2,818.38 | Professional | 52 · Reduced service | $229.09 | $2,630.27 | $2,818.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $1,047.13 Typical High $1,122.02 | Professional | 53 · Discontinued | $91.20 | $1,047.13 | $1,122.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $524.81 Typical High $562.34 | Professional | 56 · Pre-op care only | $45.71 | $524.81 | $562.34 |
Where Minnesota sits
The same service costs 5.8 times more in Oklahoma than in Mississippi. 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 $20,151MS $3,466
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.