How much rates vary
Facilitymedian $2,089 · 10th to 90th $759 to $7,413Professionalmedian $1,549 · 10th to 90th $759 to $2,818
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 $758.58 Median $758.58 Typical High $758.58 | Facility | None | $758.58 | $758.58 | $758.58 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $562.34 | Facility | 54 · Surgery only | $562.34 | $562.34 | $562.34 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | 55 · Aftercare only | $112.20 | $112.20 | $112.20 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $524.81 | Facility | 78 · Unplanned return to OR | $524.81 | $524.81 | $524.81 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $776.25 | Professional | None | $758.58 | $758.58 | $776.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $575.44 | Professional | 54 · Surgery only | $562.34 | $562.34 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $114.82 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $537.03 |
BCBS Minnesota Setting Facility Modifier None Typical Low $3,981.07 Median $6,309.57 Typical High $12,302.69 | Facility | None | $3,981.07 | $6,309.57 | $12,302.69 |
BCBS Minnesota Setting Professional Modifier None Typical Low $1,174.90 Median $1,548.82 Typical High $2,570.40 | Professional | None | $1,174.90 | $1,548.82 | $2,570.40 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,230.27 Typical High $1,995.26 | Professional | 54 · Surgery only | $933.25 | $1,230.27 | $1,995.26 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $309.03 Typical High $501.19 | Professional | 55 · Aftercare only | $234.42 | $309.03 | $501.19 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,318.26 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $977.24 | $1,318.26 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $1,905.46 Typical High $3,630.78 | Facility | None | $1,230.27 | $1,905.46 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,995.26 Typical High $3,162.28 | Professional | None | $1,174.90 | $1,995.26 | $3,162.28 |
Health Partners Setting Facility Modifier None Typical Low $1,096.48 Median $1,778.28 Typical High $3,090.30 | Facility | None | $1,096.48 | $1,778.28 | $3,090.30 |
Health Partners Setting Professional Modifier None Typical Low $1,047.13 Median $1,862.09 Typical High $2,951.21 | Professional | None | $1,047.13 | $1,862.09 | $2,951.21 |
Medica Setting Facility Modifier None Typical Low $1,348.96 Median $2,818.38 Typical High $7,762.47 | Facility | None | $1,348.96 | $2,818.38 | $7,762.47 |
Medica Setting Professional Modifier None Typical Low $794.33 Median $1,479.11 Typical High $6,165.95 | Professional | None | $794.33 | $1,479.11 | $6,165.95 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $3,090.30 Typical High $8,511.38 | Facility | None | $1,995.26 | $3,090.30 | $8,511.38 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,318.26 Typical High $2,691.53 | Professional | None | $758.58 | $1,318.26 | $2,691.53 |
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 $380.19 Median $380.19 Typical High $380.19 | Facility | 52 · Reduced service | $380.19 | $380.19 | $380.19 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $151.36 | Facility | 53 · Discontinued | $151.36 | $151.36 | $151.36 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | 56 · Pre-op care only | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $380.19 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $154.88 | Professional | 53 · Discontinued | $151.36 | $151.36 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $75.86 |
Where Minnesota sits
The same service costs 3.3 times more in Wisconsin than in Hawaii. 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
WI $7,931HI $2,400
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.