How much rates vary
Facilitymedian $1,318 · 10th to 90th $331 to $6,457Professionalmedian $871 · 10th to 90th $468 to $1,660
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 $331.13 Median $501.19 Typical High $501.19 | Facility | None | $331.13 | $501.19 | $501.19 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $251.19 Median $380.19 Typical High $380.19 | Facility | 54 · Surgery only | $251.19 | $380.19 | $380.19 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $50.12 Median $75.86 Typical High $75.86 | Facility | 55 · Aftercare only | $50.12 | $75.86 | $75.86 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $354.81 Typical High $354.81 | Facility | 78 · Unplanned return to OR | $234.42 | $354.81 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $489.78 Typical High $512.86 | Professional | None | $331.13 | $489.78 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $363.08 Typical High $380.19 | Professional | 54 · Surgery only | $251.19 | $363.08 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $72.44 Typical High $75.86 | Professional | 55 · Aftercare only | $50.12 | $72.44 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $338.84 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $234.42 | $338.84 | $354.81 |
BCBS Minnesota Setting Facility Modifier None Typical Low $4,265.80 Median $7,244.36 Typical High $14,454.40 | Facility | None | $4,265.80 | $7,244.36 | $14,454.40 |
BCBS Minnesota Setting Professional Modifier None Typical Low $562.34 Median $912.01 Typical High $1,479.11 | Professional | None | $562.34 | $912.01 | $1,479.11 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $724.44 Typical High $1,174.90 | Professional | 54 · Surgery only | $446.68 | $724.44 | $1,174.90 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $181.97 Typical High $288.40 | Professional | 55 · Aftercare only | $112.20 | $181.97 | $288.40 |
BCBS Minnesota Setting Professional Modifier 62 · Two surgeons Typical Low $354.81 Median $575.44 Typical High $891.25 | Professional | 62 · Two surgeons | $354.81 | $575.44 | $891.25 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $758.58 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $478.63 | $758.58 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,288.25 Typical High $2,454.71 | Facility | None | $831.76 | $1,288.25 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $1,047.13 Typical High $1,737.80 | Professional | None | $562.34 | $1,047.13 | $1,737.80 |
Health Partners Setting Facility Modifier None Typical Low $741.31 Median $1,174.90 Typical High $2,041.74 | Facility | None | $741.31 | $1,174.90 | $2,041.74 |
Health Partners Setting Professional Modifier None Typical Low $549.54 Median $954.99 Typical High $1,698.24 | Professional | None | $549.54 | $954.99 | $1,698.24 |
Medica Setting Facility Modifier None Typical Low $588.84 Median $1,778.28 Typical High $5,754.40 | Facility | None | $588.84 | $1,778.28 | $5,754.40 |
Medica Setting Professional Modifier None Typical Low $549.54 Median $1,148.15 Typical High $3,715.35 | Professional | None | $549.54 | $1,148.15 | $3,715.35 |
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 $380.19 Median $758.58 Typical High $1,584.89 | Professional | None | $380.19 | $758.58 | $1,584.89 |
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 $165.96 Median $251.19 Typical High $251.19 | Facility | 52 · Reduced service | $165.96 | $251.19 | $251.19 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $66.07 Median $100.00 Typical High $100.00 | Facility | 53 · Discontinued | $66.07 | $100.00 | $100.00 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $33.11 Median $50.12 Typical High $50.12 | Facility | 56 · Pre-op care only | $33.11 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $165.96 Median $245.47 Typical High $251.19 | Professional | 52 · Reduced service | $165.96 | $245.47 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $97.72 Typical High $100.00 | Professional | 53 · Discontinued | $66.07 | $97.72 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $48.98 Typical High $50.12 | Professional | 56 · Pre-op care only | $33.11 | $48.98 | $50.12 |
Where Minnesota sits
The same service costs 6.4 times more in Colorado than in West Virginia. 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 $6,390WV $1,003
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.