How much rates vary
Facilitymedian $1,995 · 10th to 90th $537 to $6,918Professionalmedian $1,122 · 10th to 90th $537 to $2,042
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 $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | 54 · Surgery only | $398.11 | $398.11 | $398.11 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $79.43 | Facility | 55 · Aftercare only | $79.43 | $79.43 | $79.43 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | 78 · Unplanned return to OR | $371.54 | $371.54 | $371.54 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $562.34 | Professional | None | $537.03 | $537.03 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $416.87 | Professional | 54 · Surgery only | $398.11 | $398.11 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $83.18 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $371.54 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $371.54 | $371.54 | $389.05 |
BCBS Minnesota Setting Facility Modifier None Typical Low $2,951.21 Median $5,888.44 Typical High $12,302.69 | Facility | None | $2,951.21 | $5,888.44 | $12,302.69 |
BCBS Minnesota Setting Professional Modifier None Typical Low $851.14 Median $1,148.15 Typical High $1,819.70 | Professional | None | $851.14 | $1,148.15 | $1,819.70 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $912.01 Typical High $1,445.44 | Professional | 54 · Surgery only | $676.08 | $912.01 | $1,445.44 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $229.09 Typical High $363.08 | Professional | 55 · Aftercare only | $169.82 | $229.09 | $363.08 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $954.99 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $724.44 | $954.99 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $1,348.96 Typical High $2,630.27 | Facility | None | $870.96 | $1,348.96 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,412.54 Typical High $2,238.72 | Professional | None | $831.76 | $1,412.54 | $2,238.72 |
Health Partners Setting Facility Modifier None Typical Low $776.25 Median $1,258.93 Typical High $2,187.76 | Facility | None | $776.25 | $1,258.93 | $2,187.76 |
Health Partners Setting Professional Modifier None Typical Low $741.31 Median $1,318.26 Typical High $2,137.96 | Professional | None | $741.31 | $1,318.26 | $2,137.96 |
Medica Setting Facility Modifier None Typical Low $933.25 Median $2,754.23 Typical High $7,762.47 | Facility | None | $933.25 | $2,754.23 | $7,762.47 |
Medica Setting Professional Modifier None Typical Low $602.56 Median $1,096.48 Typical High $5,128.61 | Professional | None | $602.56 | $1,096.48 | $5,128.61 |
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 $549.54 Median $977.24 Typical High $1,949.84 | Professional | None | $549.54 | $977.24 | $1,949.84 |
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 $269.15 Median $269.15 Typical High $269.15 | Facility | 52 · Reduced service | $269.15 | $269.15 | $269.15 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | 53 · Discontinued | $107.15 | $107.15 | $107.15 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | 56 · Pre-op care only | $53.70 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $269.15 Median $269.15 Typical High $275.42 | Professional | 52 · Reduced service | $269.15 | $269.15 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $109.65 | Professional | 53 · Discontinued | $107.15 | $107.15 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $54.95 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $54.95 |
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 $1,288.25 Median $1,698.24 Typical High $2,754.23 | Professional | 50 · Both sides | $1,288.25 | $1,698.24 | $2,754.23 |
BCBS Minnesota Setting Professional Modifier 62 · Two surgeons Typical Low $537.03 Median $724.44 Typical High $1,122.02 | Professional | 62 · Two surgeons | $537.03 | $724.44 | $1,122.02 |
Where Minnesota sits
The same service costs 4.3 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 $7,406MT $1,722
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.