How much rates vary
Facilitymedian $1,995 · 10th to 90th $676 to $9,120Professionalmedian $1,318 · 10th to 90th $794 to $2,512
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 $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $512.86 | Facility | 54 · Surgery only | $512.86 | $512.86 | $512.86 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | 55 · Aftercare only | $102.33 | $102.33 | $102.33 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $478.63 | Facility | 78 · Unplanned return to OR | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $851.14 | Professional | None | $676.08 | $676.08 | $851.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $602.56 | Professional | 54 · Surgery only | $512.86 | $512.86 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $120.23 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $562.34 |
BCBS Minnesota Setting Facility Modifier None Typical Low $4,897.79 Median $9,120.11 Typical High $19,952.62 | Facility | None | $4,897.79 | $9,120.11 | $19,952.62 |
BCBS Minnesota Setting Professional Modifier None Typical Low $954.99 Median $1,318.26 Typical High $2,187.76 | Professional | None | $954.99 | $1,318.26 | $2,187.76 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $1,047.13 Typical High $1,737.80 | Professional | 54 · Surgery only | $776.25 | $1,047.13 | $1,737.80 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $263.03 Typical High $426.58 | Professional | 55 · Aftercare only | $194.98 | $263.03 | $426.58 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,096.48 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $812.83 | $1,096.48 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $977.24 Median $1,513.56 Typical High $2,884.03 | Facility | None | $977.24 | $1,513.56 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,698.24 Typical High $2,630.27 | Professional | None | $1,148.15 | $1,698.24 | $2,630.27 |
Health Partners Setting Facility Modifier None Typical Low $870.96 Median $1,412.54 Typical High $2,454.71 | Facility | None | $870.96 | $1,412.54 | $2,454.71 |
Health Partners Setting Professional Modifier None Typical Low $977.24 Median $1,479.11 Typical High $2,398.83 | Professional | None | $977.24 | $1,479.11 | $2,398.83 |
Medica Setting Facility Modifier None Typical Low $1,047.13 Median $2,818.38 Typical High $8,317.64 | Facility | None | $1,047.13 | $2,818.38 | $8,317.64 |
Medica Setting Professional Modifier None Typical Low $794.33 Median $1,288.25 Typical High $2,630.27 | Professional | None | $794.33 | $1,288.25 | $2,630.27 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $3,090.30 Typical High $9,549.93 | Facility | None | $1,995.26 | $3,090.30 | $9,549.93 |
United Setting Professional Modifier None Typical Low $741.31 Median $1,258.93 Typical High $2,630.27 | Professional | None | $741.31 | $1,258.93 | $2,630.27 |
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 $338.84 Median $338.84 Typical High $338.84 | Facility | 52 · Reduced service | $338.84 | $338.84 | $338.84 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | 53 · Discontinued | $134.90 | $134.90 | $134.90 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | 56 · Pre-op care only | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $338.84 Median $338.84 Typical High $398.11 | Professional | 52 · Reduced service | $338.84 | $338.84 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $162.18 | Professional | 53 · Discontinued | $134.90 | $134.90 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $81.28 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $81.28 |
Where Minnesota sits
The same service costs 4.7 times more in Wisconsin than in Kentucky. 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 $8,213KY $1,765
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.