How much rates vary
Facilitymedian $2,138 · 10th to 90th $603 to $10,715Professionalmedian $1,230 · 10th to 90th $741 to $2,239
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 $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $457.09 | Facility | 54 · Surgery only | $457.09 | $457.09 | $457.09 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | 55 · Aftercare only | $91.20 | $91.20 | $91.20 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $426.58 | Facility | 78 · Unplanned return to OR | $426.58 | $426.58 | $426.58 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $758.58 | Professional | None | $602.56 | $602.56 | $758.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $549.54 | Professional | 54 · Surgery only | $457.09 | $457.09 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $109.65 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $426.58 | $426.58 | $512.86 |
BCBS Minnesota Setting Facility Modifier None Typical Low $3,235.94 Median $9,120.11 Typical High $20,417.38 | Facility | None | $3,235.94 | $9,120.11 | $20,417.38 |
BCBS Minnesota Setting Professional Modifier None Typical Low $912.01 Median $1,230.27 Typical High $1,995.26 | Professional | None | $912.01 | $1,230.27 | $1,995.26 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $977.24 Typical High $1,584.89 | Professional | 54 · Surgery only | $724.44 | $977.24 | $1,584.89 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $245.47 Typical High $389.05 | Professional | 55 · Aftercare only | $181.97 | $245.47 | $389.05 |
BCBS Minnesota Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $776.25 Typical High $1,230.27 | Professional | 62 · Two surgeons | $575.44 | $776.25 | $1,230.27 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $1,023.29 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $776.25 | $1,023.29 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $1,380.38 Typical High $2,630.27 | Facility | None | $870.96 | $1,380.38 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,513.56 Typical High $2,344.23 | Professional | None | $1,023.29 | $1,513.56 | $2,344.23 |
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 $891.25 Median $1,318.26 Typical High $2,187.76 | Professional | None | $891.25 | $1,318.26 | $2,187.76 |
Medica Setting Facility Modifier None Typical Low $933.25 Median $4,677.35 Typical High $10,715.19 | Facility | None | $933.25 | $4,677.35 | $10,715.19 |
Medica Setting Professional Modifier None Typical Low $741.31 Median $1,174.90 Typical High $2,398.83 | Professional | None | $741.31 | $1,174.90 | $2,398.83 |
United Setting Facility Modifier None Typical Low $3,235.94 Median $5,370.32 Typical High $12,882.50 | Facility | None | $3,235.94 | $5,370.32 | $12,882.50 |
United Setting Professional Modifier None Typical Low $691.83 Median $1,174.90 Typical High $2,454.71 | Professional | None | $691.83 | $1,174.90 | $2,454.71 |
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 $302.00 Median $302.00 Typical High $302.00 | Facility | 52 · Reduced service | $302.00 | $302.00 | $302.00 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | 53 · Discontinued | $120.23 | $120.23 | $120.23 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | 56 · Pre-op care only | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $302.00 Median $302.00 Typical High $363.08 | Professional | 52 · Reduced service | $302.00 | $302.00 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $144.54 | Professional | 53 · Discontinued | $120.23 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $60.26 Typical High $72.44 | Professional | 56 · Pre-op care only | $60.26 | $60.26 | $72.44 |
Where Minnesota sits
The same service costs 5.8 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 $10,507MT $1,825
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.