How much rates vary
Facilitymedian $692 · 10th to 90th $162 to $3,981Professionalmedian $479 · 10th to 90th $251 to $933
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 $162.18 Median $251.19 Typical High $251.19 | Facility | None | $162.18 | $251.19 | $251.19 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $120.23 Median $186.21 Typical High $186.21 | Facility | 54 · Surgery only | $120.23 | $186.21 | $186.21 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $24.55 Median $38.02 Typical High $38.02 | Facility | 55 · Aftercare only | $24.55 | $38.02 | $38.02 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $173.78 Typical High $173.78 | Facility | 78 · Unplanned return to OR | $112.20 | $173.78 | $173.78 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $251.19 Typical High $281.84 | Professional | None | $162.18 | $251.19 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $186.21 Typical High $199.53 | Professional | 54 · Surgery only | $120.23 | $186.21 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $38.02 Typical High $39.81 | Professional | 55 · Aftercare only | $24.55 | $38.02 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $173.78 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $112.20 | $173.78 | $186.21 |
BCBS Minnesota Setting Facility Modifier None Typical Low $977.24 Median $5,128.61 Typical High $12,302.69 | Facility | None | $977.24 | $5,128.61 | $12,302.69 |
BCBS Minnesota Setting Professional Modifier None Typical Low $275.42 Median $457.09 Typical High $794.33 | Professional | None | $275.42 | $457.09 | $794.33 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $363.08 Typical High $630.96 | Professional | 54 · Surgery only | $223.87 | $363.08 | $630.96 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $93.33 Typical High $158.49 | Professional | 55 · Aftercare only | $54.95 | $93.33 | $158.49 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $380.19 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $234.42 | $380.19 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $676.08 Typical High $1,288.25 | Facility | None | $436.52 | $676.08 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $616.60 Typical High $1,122.02 | Professional | None | $371.54 | $616.60 | $1,122.02 |
Health Partners Setting Facility Modifier None Typical Low $380.19 Median $616.60 Typical High $1,071.52 | Facility | None | $380.19 | $616.60 | $1,071.52 |
Health Partners Setting Professional Modifier None Typical Low $323.59 Median $575.44 Typical High $1,047.13 | Professional | None | $323.59 | $575.44 | $1,047.13 |
Medica Setting Facility Modifier None Typical Low $288.40 Median $1,023.29 Typical High $3,162.28 | Facility | None | $288.40 | $1,023.29 | $3,162.28 |
Medica Setting Professional Modifier None Typical Low $302.00 Median $691.83 Typical High $1,905.46 | Professional | None | $302.00 | $691.83 | $1,905.46 |
United Setting Facility Modifier None Typical Low $776.25 Median $1,659.59 Typical High $4,897.79 | Facility | None | $776.25 | $1,659.59 | $4,897.79 |
United Setting Professional Modifier None Typical Low $229.09 Median $478.63 Typical High $933.25 | Professional | None | $229.09 | $478.63 | $933.25 |
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 $81.28 Median $125.89 Typical High $125.89 | Facility | 52 · Reduced service | $81.28 | $125.89 | $125.89 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $32.36 Median $50.12 Typical High $50.12 | Facility | 53 · Discontinued | $32.36 | $50.12 | $50.12 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $16.22 Median $25.12 Typical High $25.12 | Facility | 56 · Pre-op care only | $16.22 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $81.28 Median $125.89 Typical High $131.83 | Professional | 52 · Reduced service | $81.28 | $125.89 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $50.12 Typical High $52.48 | Professional | 53 · Discontinued | $32.36 | $50.12 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $25.12 Typical High $26.30 | Professional | 56 · Pre-op care only | $16.22 | $25.12 | $26.30 |
Where Minnesota sits
The same service costs 4.3 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.
Minnesota· 4th of 51
$490
WI $794KY $186
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.