How much rates vary
Facilitymedian $1,175 · 10th to 90th $302 to $6,457Professionalmedian $776 · 10th to 90th $398 to $1,514
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 $302.00 Median $446.68 Typical High $446.68 | Facility | None | $302.00 | $446.68 | $446.68 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $229.09 Median $338.84 Typical High $338.84 | Facility | 54 · Surgery only | $229.09 | $338.84 | $338.84 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $45.71 Median $67.61 Typical High $67.61 | Facility | 55 · Aftercare only | $45.71 | $67.61 | $67.61 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $316.23 Typical High $316.23 | Facility | 78 · Unplanned return to OR | $213.80 | $316.23 | $316.23 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $436.52 Typical High $446.68 | Professional | None | $302.00 | $436.52 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $323.59 Typical High $338.84 | Professional | 54 · Surgery only | $229.09 | $323.59 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $64.57 Typical High $67.61 | Professional | 55 · Aftercare only | $45.71 | $64.57 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $302.00 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $213.80 | $302.00 | $316.23 |
BCBS 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 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 Setting Professional Modifier None Typical Low $478.63 Median $794.33 Typical High $1,348.96 | Professional | None | $478.63 | $794.33 | $1,348.96 |
BCBS Setting Professional Modifier 50 · Both sides Typical Low $707.95 Median $1,202.26 Typical High $2,041.74 | Professional | 50 · Both sides | $707.95 | $1,202.26 | $2,041.74 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $645.65 Typical High $1,071.52 | Professional | 54 · Surgery only | $380.19 | $645.65 | $1,071.52 |
BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $165.96 Typical High $269.15 | Professional | 55 · Aftercare only | $102.33 | $165.96 | $269.15 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $676.08 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $398.11 | $676.08 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,148.15 Typical High $2,187.76 | Facility | None | $741.31 | $1,148.15 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $954.99 Typical High $1,584.89 | Professional | None | $501.19 | $954.99 | $1,584.89 |
Health Partners Setting Facility Modifier None Typical Low $645.65 Median $1,047.13 Typical High $1,819.70 | Facility | None | $645.65 | $1,047.13 | $1,819.70 |
Health Partners Setting Professional Modifier None Typical Low $501.19 Median $870.96 Typical High $1,513.56 | Professional | None | $501.19 | $870.96 | $1,513.56 |
Medica Setting Facility Modifier None Typical Low $524.81 Median $1,659.59 Typical High $4,786.30 | Facility | None | $524.81 | $1,659.59 | $4,786.30 |
Medica Setting Professional Modifier None Typical Low $501.19 Median $1,023.29 Typical High $3,311.31 | Professional | None | $501.19 | $1,023.29 | $3,311.31 |
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 $354.81 Median $691.83 Typical High $1,445.44 | Professional | None | $354.81 | $691.83 | $1,445.44 |
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 $151.36 Median $223.87 Typical High $223.87 | Facility | 52 · Reduced service | $151.36 | $223.87 | $223.87 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $60.26 Median $89.13 Typical High $89.13 | Facility | 53 · Discontinued | $60.26 | $89.13 | $89.13 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $30.20 Median $44.67 Typical High $44.67 | Facility | 56 · Pre-op care only | $30.20 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $151.36 Median $218.78 Typical High $223.87 | Professional | 52 · Reduced service | $151.36 | $218.78 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $87.10 Typical High $89.13 | Professional | 53 · Discontinued | $60.26 | $87.10 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $43.65 Typical High $44.67 | Professional | 56 · Pre-op care only | $30.20 | $43.65 | $44.67 |
Where Minnesota sits
The same service costs 5.7 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 $6,346MT $1,110
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.