How much rates vary
Facilitymedian $2,455 · 10th to 90th $912 to $10,000Professionalmedian $1,905 · 10th to 90th $912 to $3,388
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 $912.01 Median $912.01 Typical High $912.01 | Facility | None | $912.01 | $912.01 | $912.01 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $691.83 | Facility | 54 · Surgery only | $691.83 | $691.83 | $691.83 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | 55 · Aftercare only | $138.04 | $138.04 | $138.04 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $645.65 | Facility | 78 · Unplanned return to OR | $645.65 | $645.65 | $645.65 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $933.25 | Professional | None | $912.01 | $912.01 | $933.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $691.83 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $645.65 |
BCBS Minnesota Setting Facility Modifier None Typical Low $4,677.35 Median $12,302.69 Typical High $26,915.35 | Facility | None | $4,677.35 | $12,302.69 | $26,915.35 |
BCBS Minnesota Setting Professional Modifier None Typical Low $1,513.56 Median $1,905.46 Typical High $2,951.21 | Professional | None | $1,513.56 | $1,905.46 | $2,951.21 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,513.56 Typical High $2,398.83 | Professional | 54 · Surgery only | $1,230.27 | $1,513.56 | $2,398.83 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $389.05 Typical High $588.84 | Professional | 55 · Aftercare only | $302.00 | $389.05 | $588.84 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,621.81 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,621.81 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $2,344.23 Typical High $4,466.84 | Facility | None | $1,513.56 | $2,344.23 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $2,454.71 Typical High $3,890.45 | Professional | None | $1,445.44 | $2,454.71 | $3,890.45 |
Health Partners Setting Facility Modifier None Typical Low $1,348.96 Median $2,137.96 Typical High $3,801.89 | Facility | None | $1,348.96 | $2,137.96 | $3,801.89 |
Health Partners Setting Professional Modifier None Typical Low $1,288.25 Median $2,238.72 Typical High $3,630.78 | Professional | None | $1,288.25 | $2,238.72 | $3,630.78 |
Medica Setting Facility Modifier None Typical Low $1,584.89 Median $2,754.23 Typical High $7,762.47 | Facility | None | $1,584.89 | $2,754.23 | $7,762.47 |
Medica Setting Professional Modifier None Typical Low $933.25 Median $1,778.28 Typical High $6,760.83 | Professional | None | $933.25 | $1,778.28 | $6,760.83 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $3,090.30 Typical High $10,000.00 | Facility | None | $1,995.26 | $3,090.30 | $10,000.00 |
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 $457.09 Median $457.09 Typical High $457.09 | Facility | 52 · Reduced service | $457.09 | $457.09 | $457.09 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $181.97 | Facility | 53 · Discontinued | $181.97 | $181.97 | $181.97 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | 56 · Pre-op care only | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $186.21 | Professional | 53 · Discontinued | $181.97 | $181.97 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $93.33 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $93.33 |
Where Minnesota sits
The same service costs 4.2 times more in Colorado 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
CO $12,508MT $2,994
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.