How much rates vary
Facilitymedian $3,236 · 10th to 90th $955 to $10,965Professionalmedian $1,950 · 10th to 90th $1,175 to $3,548
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 $954.99 Median $954.99 Typical High $954.99 | Facility | None | $954.99 | $954.99 | $954.99 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $724.44 | Facility | 54 · Surgery only | $724.44 | $724.44 | $724.44 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | 55 · Aftercare only | $144.54 | $144.54 | $144.54 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | 78 · Unplanned return to OR | $676.08 | $676.08 | $676.08 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,202.26 | Professional | None | $954.99 | $954.99 | $1,202.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $870.96 | Professional | 54 · Surgery only | $724.44 | $724.44 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $173.78 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $812.83 |
BCBS Minnesota Setting Facility Modifier None Typical Low $5,128.61 Median $10,232.93 Typical High $20,417.38 | Facility | None | $5,128.61 | $10,232.93 | $20,417.38 |
BCBS Minnesota Setting Professional Modifier None Typical Low $1,445.44 Median $1,949.84 Typical High $3,162.28 | Professional | None | $1,445.44 | $1,949.84 | $3,162.28 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,548.82 Typical High $2,570.40 | Professional | 54 · Surgery only | $1,174.90 | $1,548.82 | $2,570.40 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $389.05 Typical High $616.60 | Professional | 55 · Aftercare only | $288.40 | $389.05 | $616.60 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,659.59 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,659.59 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $2,187.76 Typical High $4,168.69 | Facility | None | $1,380.38 | $2,187.76 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $2,398.83 Typical High $3,715.35 | Professional | None | $1,621.81 | $2,398.83 | $3,715.35 |
Health Partners Setting Facility Modifier None Typical Low $1,230.27 Median $1,995.26 Typical High $3,467.37 | Facility | None | $1,230.27 | $1,995.26 | $3,467.37 |
Health Partners Setting Professional Modifier None Typical Low $1,412.54 Median $2,089.30 Typical High $3,467.37 | Professional | None | $1,412.54 | $2,089.30 | $3,467.37 |
Medica Setting Facility Modifier None Typical Low $1,479.11 Median $4,677.35 Typical High $10,715.19 | Facility | None | $1,479.11 | $4,677.35 | $10,715.19 |
Medica Setting Professional Modifier None Typical Low $1,174.90 Median $1,862.09 Typical High $3,801.89 | Professional | None | $1,174.90 | $1,862.09 | $3,801.89 |
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 $1,096.48 Median $1,862.09 Typical High $3,890.45 | Professional | None | $1,096.48 | $1,862.09 | $3,890.45 |
7 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 $478.63 Median $478.63 Typical High $478.63 | Facility | 52 · Reduced service | $478.63 | $478.63 | $478.63 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | 53 · Discontinued | $190.55 | $190.55 | $190.55 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | 56 · Pre-op care only | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $478.63 Median $478.63 Typical High $575.44 | Professional | 52 · Reduced service | $478.63 | $478.63 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $229.09 | Professional | 53 · Discontinued | $190.55 | $190.55 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $114.82 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $114.82 |
BCBS Minnesota Setting Professional Modifier 62 · Two surgeons Typical Low $912.01 Median $1,230.27 Typical High $1,949.84 | Professional | 62 · Two surgeons | $912.01 | $1,230.27 | $1,949.84 |
Where Minnesota sits
The same service costs 4.0 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 $11,674MT $2,925
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.