How much rates vary
Facilitymedian $1,995 · 10th to 90th $646 to $7,079Professionalmedian $1,349 · 10th to 90th $646 to $2,512
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 $645.65 Median $645.65 Typical High $645.65 | Facility | None | $645.65 | $645.65 | $645.65 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | 54 · Surgery only | $489.78 | $489.78 | $489.78 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | 55 · Aftercare only | $97.72 | $97.72 | $97.72 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $457.09 | Facility | 78 · Unplanned return to OR | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $676.08 | Professional | None | $645.65 | $645.65 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $457.09 |
BCBS Setting Facility Modifier None Typical Low $3,467.37 Median $6,165.95 Typical High $12,302.69 | Facility | None | $3,467.37 | $6,165.95 | $12,302.69 |
BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $2,238.72 | Professional | None | $1,023.29 | $1,380.38 | $2,238.72 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,096.48 Typical High $1,778.28 | Professional | 54 · Surgery only | $812.83 | $1,096.48 | $1,778.28 |
BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $275.42 Typical High $446.68 | Professional | 55 · Aftercare only | $204.17 | $275.42 | $446.68 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,148.15 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $851.14 | $1,148.15 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $1,659.59 Typical High $3,162.28 | Facility | None | $1,071.52 | $1,659.59 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,737.80 Typical High $2,754.23 | Professional | None | $1,023.29 | $1,737.80 | $2,754.23 |
Health Partners Setting Facility Modifier None Typical Low $954.99 Median $1,513.56 Typical High $2,630.27 | Facility | None | $954.99 | $1,513.56 | $2,630.27 |
Health Partners Setting Professional Modifier None Typical Low $912.01 Median $1,584.89 Typical High $2,570.40 | Professional | None | $912.01 | $1,584.89 | $2,570.40 |
Medica Setting Facility Modifier None Typical Low $1,122.02 Median $2,818.38 Typical High $7,762.47 | Facility | None | $1,122.02 | $2,818.38 | $7,762.47 |
Medica Setting Professional Modifier None Typical Low $691.83 Median $1,258.93 Typical High $4,786.30 | Professional | None | $691.83 | $1,258.93 | $4,786.30 |
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 $645.65 Median $1,148.15 Typical High $2,344.23 | Professional | None | $645.65 | $1,148.15 | $2,344.23 |
8 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 $323.59 Median $323.59 Typical High $323.59 | Facility | 52 · Reduced service | $323.59 | $323.59 | $323.59 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | 53 · Discontinued | $128.82 | $128.82 | $128.82 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | 56 · Pre-op care only | $64.57 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $323.59 Median $323.59 Typical High $331.13 | Professional | 52 · Reduced service | $323.59 | $323.59 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $131.83 | Professional | 53 · Discontinued | $128.82 | $128.82 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $66.07 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $66.07 |
BCBS Setting Facility Modifier 50 · Both sides Typical Low $6,456.54 Median $12,022.64 Typical High $21,379.62 | Facility | 50 · Both sides | $6,456.54 | $12,022.64 | $21,379.62 |
BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $2,089.30 Typical High $3,388.44 | Professional | 50 · Both sides | $1,513.56 | $2,089.30 | $3,388.44 |
Where Minnesota sits
The same service costs 3.7 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 $7,647MT $2,070
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.