How much rates vary
Facilitymedian $1,995 · 10th to 90th $501 to $6,918Professionalmedian $1,023 · 10th to 90th $501 to $1,862
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 $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $380.19 | Facility | 54 · Surgery only | $380.19 | $380.19 | $380.19 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | 55 · Aftercare only | $75.86 | $75.86 | $75.86 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $354.81 Typical High $354.81 | Facility | 78 · Unplanned return to OR | $354.81 | $354.81 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $630.96 | Professional | None | $501.19 | $501.19 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 54 · Surgery only | $380.19 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $354.81 | $354.81 | $354.81 |
BCBS Minnesota Setting Facility Modifier None Typical Low $2,630.27 Median $5,623.41 Typical High $12,302.69 | Facility | None | $2,630.27 | $5,623.41 | $12,302.69 |
BCBS Minnesota Setting Professional Modifier None Typical Low $794.33 Median $1,047.13 Typical High $1,698.24 | Professional | None | $794.33 | $1,047.13 | $1,698.24 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $831.76 Typical High $1,318.26 | Professional | 54 · Surgery only | $645.65 | $831.76 | $1,318.26 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $213.80 Typical High $331.13 | Professional | 55 · Aftercare only | $158.49 | $213.80 | $331.13 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $891.25 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $676.08 | $891.25 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,288.25 Typical High $2,454.71 | Facility | None | $831.76 | $1,288.25 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,348.96 Typical High $2,137.96 | Professional | None | $794.33 | $1,348.96 | $2,137.96 |
Health Partners Setting Facility Modifier None Typical Low $741.31 Median $1,174.90 Typical High $2,089.30 | Facility | None | $741.31 | $1,174.90 | $2,089.30 |
Health Partners Setting Professional Modifier None Typical Low $707.95 Median $1,230.27 Typical High $1,995.26 | Professional | None | $707.95 | $1,230.27 | $1,995.26 |
Medica Setting Facility Modifier None Typical Low $954.99 Median $2,754.23 Typical High $7,762.47 | Facility | None | $954.99 | $2,754.23 | $7,762.47 |
Medica Setting Professional Modifier None Typical Low $524.81 Median $977.24 Typical High $5,011.87 | Professional | None | $524.81 | $977.24 | $5,011.87 |
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 $501.19 Median $891.25 Typical High $1,778.28 | Professional | None | $501.19 | $891.25 | $1,778.28 |
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 $251.19 Median $251.19 Typical High $251.19 | Facility | 52 · Reduced service | $251.19 | $251.19 | $251.19 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | 53 · Discontinued | $100.00 | $100.00 | $100.00 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | 56 · Pre-op care only | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $251.19 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $102.33 | Professional | 53 · Discontinued | $100.00 | $100.00 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $50.12 |
Where Minnesota sits
The same service costs 4.5 times more in Wisconsin than in Montana. 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 $7,285MT $1,607
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.