How much rates vary
Facilitymedian $1,288 · 10th to 90th $324 to $6,457Professionalmedian $851 · 10th to 90th $447 to $1,585
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 $323.59 Median $489.78 Typical High $489.78 | Facility | None | $323.59 | $489.78 | $489.78 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $245.47 Median $371.54 Typical High $371.54 | Facility | 54 · Surgery only | $245.47 | $371.54 | $371.54 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $48.98 Median $74.13 Typical High $74.13 | Facility | 55 · Aftercare only | $48.98 | $74.13 | $74.13 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $346.74 Typical High $346.74 | Facility | 78 · Unplanned return to OR | $229.09 | $346.74 | $346.74 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $478.63 Typical High $501.19 | Professional | None | $323.59 | $478.63 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $354.81 Typical High $371.54 | Professional | 54 · Surgery only | $245.47 | $354.81 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $70.79 Typical High $74.13 | Professional | 55 · Aftercare only | $48.98 | $70.79 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $331.13 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $229.09 | $331.13 | $346.74 |
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 $549.54 Median $891.25 Typical High $1,412.54 | Professional | None | $549.54 | $891.25 | $1,412.54 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $707.95 Typical High $1,148.15 | Professional | 54 · Surgery only | $446.68 | $707.95 | $1,148.15 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $181.97 Typical High $281.84 | Professional | 55 · Aftercare only | $112.20 | $181.97 | $281.84 |
BCBS Minnesota Setting Professional Modifier 62 · Two surgeons Typical Low $346.74 Median $562.34 Typical High $891.25 | Professional | 62 · Two surgeons | $346.74 | $562.34 | $891.25 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $741.31 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $467.74 | $741.31 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,258.93 Typical High $2,398.83 | Facility | None | $812.83 | $1,258.93 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $1,023.29 Typical High $1,698.24 | Professional | None | $549.54 | $1,023.29 | $1,698.24 |
Health Partners Setting Facility Modifier None Typical Low $707.95 Median $1,148.15 Typical High $1,995.26 | Facility | None | $707.95 | $1,148.15 | $1,995.26 |
Health Partners Setting Professional Modifier None Typical Low $537.03 Median $933.25 Typical High $1,659.59 | Professional | None | $537.03 | $933.25 | $1,659.59 |
Medica Setting Facility Modifier None Typical Low $549.54 Median $1,698.24 Typical High $6,165.95 | Facility | None | $549.54 | $1,698.24 | $6,165.95 |
Medica Setting Professional Modifier None Typical Low $537.03 Median $1,122.02 Typical High $3,630.78 | Professional | None | $537.03 | $1,122.02 | $3,630.78 |
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 $363.08 Median $724.44 Typical High $1,548.82 | Professional | None | $363.08 | $724.44 | $1,548.82 |
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 $162.18 Median $245.47 Typical High $245.47 | Facility | 52 · Reduced service | $162.18 | $245.47 | $245.47 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $66.07 Median $97.72 Typical High $97.72 | Facility | 53 · Discontinued | $66.07 | $97.72 | $97.72 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $32.36 Median $48.98 Typical High $48.98 | Facility | 56 · Pre-op care only | $32.36 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $162.18 Median $234.42 Typical High $245.47 | Professional | 52 · Reduced service | $162.18 | $234.42 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $95.50 Typical High $97.72 | Professional | 53 · Discontinued | $66.07 | $95.50 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $47.86 Typical High $48.98 | Professional | 56 · Pre-op care only | $32.36 | $47.86 | $48.98 |
Where Minnesota sits
The same service costs 11.0 times more in Vermont 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
VT $12,892MT $1,170
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.