How much rates vary
Facilitymedian $2,042 · 10th to 90th $537 to $12,589Professionalmedian $1,096 · 10th to 90th $537 to $1,950
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 $416.87 Median $4,365.16 Typical High $13,489.63 | Facility | None | $416.87 | $4,365.16 | $13,489.63 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $316.23 Median $398.11 Typical High $398.11 | Facility | 54 · Surgery only | $316.23 | $398.11 | $398.11 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $63.10 Median $79.43 Typical High $79.43 | Facility | 55 · Aftercare only | $63.10 | $79.43 | $79.43 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $371.54 Typical High $371.54 | Facility | 78 · Unplanned return to OR | $295.12 | $371.54 | $371.54 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $512.86 Typical High $588.84 | Professional | None | $416.87 | $512.86 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $371.54 Typical High $398.11 | Professional | 54 · Surgery only | $316.23 | $371.54 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $74.13 Typical High $79.43 | Professional | 55 · Aftercare only | $63.10 | $74.13 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $346.74 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $295.12 | $346.74 | $371.54 |
BCBS Minnesota Setting Facility Modifier None Typical Low $2,290.87 Median $6,309.57 Typical High $14,454.40 | Facility | None | $2,290.87 | $6,309.57 | $14,454.40 |
BCBS Minnesota Setting Facility Modifier 50 · Both sides Typical Low $7,585.78 Median $13,803.84 Typical High $25,703.96 | Facility | 50 · Both sides | $7,585.78 | $13,803.84 | $25,703.96 |
BCBS Minnesota Setting Professional Modifier None Typical Low $645.65 Median $1,122.02 Typical High $1,778.28 | Professional | None | $645.65 | $1,122.02 | $1,778.28 |
BCBS Minnesota Setting Professional Modifier 50 · Both sides Typical Low $954.99 Median $1,698.24 Typical High $2,630.27 | Professional | 50 · Both sides | $954.99 | $1,698.24 | $2,630.27 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $891.25 Typical High $1,412.54 | Professional | 54 · Surgery only | $512.86 | $891.25 | $1,412.54 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $229.09 Typical High $338.84 | Professional | 55 · Aftercare only | $141.25 | $229.09 | $338.84 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $933.25 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $537.03 | $933.25 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,318.26 Typical High $2,511.89 | Facility | None | $851.14 | $1,318.26 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,380.38 Typical High $2,238.72 | Professional | None | $851.14 | $1,380.38 | $2,238.72 |
Health Partners Setting Facility Modifier None Typical Low $758.58 Median $1,258.93 Typical High $2,137.96 | Facility | None | $758.58 | $1,258.93 | $2,137.96 |
Health Partners Setting Professional Modifier None Typical Low $741.31 Median $1,202.26 Typical High $2,041.74 | Professional | None | $741.31 | $1,202.26 | $2,041.74 |
Medica Setting Facility Modifier None Typical Low $707.95 Median $1,819.70 Typical High $6,760.83 | Facility | None | $707.95 | $1,819.70 | $6,760.83 |
Medica Setting Professional Modifier None Typical Low $616.60 Median $1,348.96 Typical High $3,311.31 | Professional | None | $616.60 | $1,348.96 | $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 $524.81 Median $954.99 Typical High $1,905.46 | Professional | None | $524.81 | $954.99 | $1,905.46 |
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 $208.93 Median $269.15 Typical High $269.15 | Facility | 52 · Reduced service | $208.93 | $269.15 | $269.15 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $83.18 Median $107.15 Typical High $107.15 | Facility | 53 · Discontinued | $83.18 | $107.15 | $107.15 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $41.69 Median $53.70 Typical High $53.70 | Facility | 56 · Pre-op care only | $41.69 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $208.93 Median $245.47 Typical High $269.15 | Professional | 52 · Reduced service | $208.93 | $245.47 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $97.72 Typical High $107.15 | Professional | 53 · Discontinued | $83.18 | $97.72 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $48.98 Typical High $53.70 | Professional | 56 · Pre-op care only | $41.69 | $48.98 | $53.70 |
Where Minnesota sits
The same service costs 5.4 times more in Wisconsin than in West Virginia. 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 $6,411WV $1,178
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.