How much rates vary
Facilitymedian $2,630 · 10th to 90th $724 to $7,943Professionalmedian $1,479 · 10th to 90th $724 to $2,692
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 $724.44 Median $724.44 Typical High $724.44 | Facility | None | $724.44 | $724.44 | $724.44 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $537.03 | Facility | 54 · Surgery only | $537.03 | $537.03 | $537.03 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | 55 · Aftercare only | $107.15 | $107.15 | $107.15 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | 78 · Unplanned return to OR | $501.19 | $501.19 | $501.19 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $812.83 | Professional | None | $724.44 | $724.44 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $549.54 | Professional | 54 · Surgery only | $537.03 | $537.03 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $109.65 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $501.19 | $501.19 | $512.86 |
BCBS Minnesota Setting Facility Modifier None Typical Low $3,890.45 Median $6,165.95 Typical High $12,302.69 | Facility | None | $3,890.45 | $6,165.95 | $12,302.69 |
BCBS Minnesota Setting Professional Modifier None Typical Low $1,122.02 Median $1,513.56 Typical High $2,398.83 | Professional | None | $1,122.02 | $1,513.56 | $2,398.83 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,202.26 Typical High $1,905.46 | Professional | 54 · Surgery only | $912.01 | $1,202.26 | $1,905.46 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $302.00 Typical High $478.63 | Professional | 55 · Aftercare only | $223.87 | $302.00 | $478.63 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,258.93 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $954.99 | $1,258.93 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $1,819.70 Typical High $3,548.13 | Facility | None | $1,174.90 | $1,819.70 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,995.26 Typical High $3,019.95 | Professional | None | $1,122.02 | $1,995.26 | $3,019.95 |
Health Partners Setting Facility Modifier None Typical Low $1,047.13 Median $1,698.24 Typical High $2,951.21 | Facility | None | $1,047.13 | $1,698.24 | $2,951.21 |
Health Partners Setting Professional Modifier None Typical Low $1,000.00 Median $1,778.28 Typical High $2,884.03 | Professional | None | $1,000.00 | $1,778.28 | $2,884.03 |
Medica Setting Facility Modifier None Typical Low $1,258.93 Median $3,630.78 Typical High $8,317.64 | Facility | None | $1,258.93 | $3,630.78 | $8,317.64 |
Medica Setting Professional Modifier None Typical Low $776.25 Median $1,412.54 Typical High $6,165.95 | Professional | None | $776.25 | $1,412.54 | $6,165.95 |
United Setting Facility Modifier None Typical Low $2,818.38 Median $4,265.80 Typical High $9,772.37 | Facility | None | $2,818.38 | $4,265.80 | $9,772.37 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,258.93 Typical High $2,630.27 | Professional | None | $724.44 | $1,258.93 | $2,630.27 |
7 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 $363.08 Median $363.08 Typical High $363.08 | Facility | 52 · Reduced service | $363.08 | $363.08 | $363.08 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | 53 · Discontinued | $144.54 | $144.54 | $144.54 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | 56 · Pre-op care only | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $363.08 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $147.91 | Professional | 53 · Discontinued | $144.54 | $144.54 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $72.44 |
BCBS Minnesota Setting Professional Modifier 62 · Two surgeons Typical Low $707.95 Median $933.25 Typical High $1,445.44 | Professional | 62 · Two surgeons | $707.95 | $933.25 | $1,445.44 |
Where Minnesota sits
The same service costs 4.4 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 $9,724MT $2,195
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.