How much rates vary
Facilitymedian $1,096 · 10th to 90th $269 to $7,762Professionalmedian $562 · 10th to 90th $269 to $1,047
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 $269.15 Median $269.15 Typical High $2,089.30 | Facility | None | $269.15 | $269.15 | $2,089.30 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | 54 · Surgery only | $204.17 | $204.17 | $204.17 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $40.74 | Facility | 55 · Aftercare only | $40.74 | $40.74 | $40.74 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | 78 · Unplanned return to OR | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $354.81 | Professional | None | $269.15 | $269.15 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $204.17 Typical High $208.93 | Professional | 54 · Surgery only | $204.17 | $204.17 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $42.66 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $190.55 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $190.55 | $190.55 | $199.53 |
BCBS Minnesota Setting Facility Modifier None Typical Low $4,365.16 Median $7,943.28 Typical High $16,595.87 | Facility | None | $4,365.16 | $7,943.28 | $16,595.87 |
BCBS Minnesota Setting Professional Modifier None Typical Low $436.52 Median $575.44 Typical High $933.25 | Professional | None | $436.52 | $575.44 | $933.25 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $457.09 Typical High $741.31 | Professional | 54 · Surgery only | $346.74 | $457.09 | $741.31 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $117.49 Typical High $186.21 | Professional | 55 · Aftercare only | $87.10 | $117.49 | $186.21 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $489.78 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $363.08 | $489.78 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $691.83 Typical High $1,318.26 | Facility | None | $446.68 | $691.83 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $724.44 Typical High $1,148.15 | Professional | None | $426.58 | $724.44 | $1,148.15 |
Health Partners Setting Facility Modifier None Typical Low $398.11 Median $645.65 Typical High $1,122.02 | Facility | None | $398.11 | $645.65 | $1,122.02 |
Health Partners Setting Professional Modifier None Typical Low $380.19 Median $660.69 Typical High $1,071.52 | Professional | None | $380.19 | $660.69 | $1,071.52 |
Medica Setting Facility Modifier None Typical Low $467.74 Median $2,137.96 Typical High $7,413.10 | Facility | None | $467.74 | $2,137.96 | $7,413.10 |
Medica Setting Professional Modifier None Typical Low $302.00 Median $562.34 Typical High $3,890.45 | Professional | None | $302.00 | $562.34 | $3,890.45 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,511.89 Typical High $8,317.64 | Facility | None | $1,513.56 | $2,511.89 | $8,317.64 |
United Setting Professional Modifier None Typical Low $281.84 Median $501.19 Typical High $1,000.00 | Professional | None | $281.84 | $501.19 | $1,000.00 |
9 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 $134.90 Median $134.90 Typical High $134.90 | Facility | 52 · Reduced service | $134.90 | $134.90 | $134.90 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | 53 · Discontinued | $53.70 | $53.70 | $53.70 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $26.92 | Facility | 56 · Pre-op care only | $26.92 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $134.90 Median $134.90 Typical High $141.25 | Professional | 52 · Reduced service | $134.90 | $134.90 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $56.23 | Professional | 53 · Discontinued | $53.70 | $53.70 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $28.18 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $28.18 |
BCBS Minnesota 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 Minnesota Setting Professional Modifier 50 · Both sides Typical Low $645.65 Median $870.96 Typical High $1,380.38 | Professional | 50 · Both sides | $645.65 | $870.96 | $1,380.38 |
BCBS Minnesota Setting Professional Modifier 62 · Two surgeons Typical Low $269.15 Median $363.08 Typical High $575.44 | Professional | 62 · Two surgeons | $269.15 | $363.08 | $575.44 |
Where Minnesota sits
The same service costs 7.3 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 $6,269MT $863
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.