How much rates vary
Facilitymedian $2,399 · 10th to 90th $891 to $7,762Professionalmedian $1,820 · 10th to 90th $891 to $3,311
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 $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | 54 · Surgery only | $676.08 | $676.08 | $676.08 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | 55 · Aftercare only | $134.90 | $134.90 | $134.90 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | 78 · Unplanned return to OR | $630.96 | $630.96 | $630.96 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $954.99 | Professional | None | $891.25 | $891.25 | $954.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $676.08 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $630.96 |
BCBS Minnesota Setting Facility Modifier None Typical Low $4,265.80 Median $6,918.31 Typical High $12,589.25 | Facility | None | $4,265.80 | $6,918.31 | $12,589.25 |
BCBS Minnesota Setting Professional Modifier None Typical Low $1,445.44 Median $1,862.09 Typical High $2,951.21 | Professional | None | $1,445.44 | $1,862.09 | $2,951.21 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,479.11 Typical High $2,344.23 | Professional | 54 · Surgery only | $1,148.15 | $1,479.11 | $2,344.23 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $371.54 Typical High $588.84 | Professional | 55 · Aftercare only | $288.40 | $371.54 | $588.84 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,584.89 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,584.89 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $2,290.87 Typical High $4,365.16 | Facility | None | $1,479.11 | $2,290.87 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $2,398.83 Typical High $3,715.35 | Professional | None | $1,412.54 | $2,398.83 | $3,715.35 |
Health Partners Setting Facility Modifier None Typical Low $1,318.26 Median $2,089.30 Typical High $3,630.78 | Facility | None | $1,318.26 | $2,089.30 | $3,630.78 |
Health Partners Setting Professional Modifier None Typical Low $1,258.93 Median $2,187.76 Typical High $3,548.13 | Professional | None | $1,258.93 | $2,187.76 | $3,548.13 |
Medica Setting Facility Modifier None Typical Low $1,548.82 Median $2,754.23 Typical High $7,762.47 | Facility | None | $1,548.82 | $2,754.23 | $7,762.47 |
Medica Setting Professional Modifier None Typical Low $954.99 Median $1,778.28 Typical High $6,760.83 | Professional | None | $954.99 | $1,778.28 | $6,760.83 |
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 $891.25 Median $1,584.89 Typical High $3,235.94 | Professional | None | $891.25 | $1,584.89 | $3,235.94 |
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 $446.68 Median $446.68 Typical High $446.68 | Facility | 52 · Reduced service | $446.68 | $446.68 | $446.68 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $177.83 | Facility | 53 · Discontinued | $177.83 | $177.83 | $177.83 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | 56 · Pre-op care only | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $446.68 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $181.97 | Professional | 53 · Discontinued | $177.83 | $177.83 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $91.20 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $91.20 |
Where Minnesota sits
The same service costs 3.0 times more in Wisconsin than in Maryland. 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 $7,993MD $2,690
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.