How much rates vary
Facilitymedian $1,995 · 10th to 90th $562 to $6,918Professionalmedian $1,175 · 10th to 90th $562 to $2,138
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 $562.34 Median $562.34 Typical High $562.34 | Facility | None | $562.34 | $562.34 | $562.34 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $426.58 | Facility | 54 · Surgery only | $426.58 | $426.58 | $426.58 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | 55 · Aftercare only | $85.11 | $85.11 | $85.11 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | 78 · Unplanned return to OR | $398.11 | $398.11 | $398.11 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $575.44 | Professional | None | $562.34 | $562.34 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | 54 · Surgery only | $426.58 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $398.11 |
BCBS Minnesota Setting Facility Modifier None Typical Low $3,019.95 Median $6,025.60 Typical High $12,302.69 | Facility | None | $3,019.95 | $6,025.60 | $12,302.69 |
BCBS Minnesota Setting Professional Modifier None Typical Low $912.01 Median $1,202.26 Typical High $1,905.46 | Professional | None | $912.01 | $1,202.26 | $1,905.46 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $954.99 Typical High $1,479.11 | Professional | 54 · Surgery only | $724.44 | $954.99 | $1,479.11 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $239.88 Typical High $371.54 | Professional | 55 · Aftercare only | $181.97 | $239.88 | $371.54 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $1,000.00 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $758.58 | $1,000.00 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $1,445.44 Typical High $2,754.23 | Facility | None | $933.25 | $1,445.44 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,513.56 Typical High $2,344.23 | Professional | None | $891.25 | $1,513.56 | $2,344.23 |
Health Partners Setting Facility Modifier None Typical Low $831.76 Median $1,318.26 Typical High $2,290.87 | Facility | None | $831.76 | $1,318.26 | $2,290.87 |
Health Partners Setting Professional Modifier None Typical Low $794.33 Median $1,380.38 Typical High $2,238.72 | Professional | None | $794.33 | $1,380.38 | $2,238.72 |
Medica Setting Facility Modifier None Typical Low $1,071.52 Median $2,818.38 Typical High $7,762.47 | Facility | None | $1,071.52 | $2,818.38 | $7,762.47 |
Medica Setting Professional Modifier None Typical Low $602.56 Median $1,122.02 Typical High $5,370.32 | Professional | None | $602.56 | $1,122.02 | $5,370.32 |
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 $562.34 Median $1,000.00 Typical High $2,041.74 | Professional | None | $562.34 | $1,000.00 | $2,041.74 |
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 $281.84 Median $281.84 Typical High $281.84 | Facility | 52 · Reduced service | $281.84 | $281.84 | $281.84 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | 53 · Discontinued | $112.20 | $112.20 | $112.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | 56 · Pre-op care only | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $281.84 Median $281.84 Typical High $288.40 | Professional | 52 · Reduced service | $281.84 | $281.84 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $114.82 | Professional | 53 · Discontinued | $112.20 | $112.20 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $57.54 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $57.54 |
Where Minnesota sits
The same service costs 4.1 times more in Oklahoma 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
OK $7,594MT $1,845
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.