How much rates vary
Facilitymedian $575 · 10th to 90th $120 to $3,981Professionalmedian $347 · 10th to 90th $170 to $708
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 $120.23 Median $208.93 Typical High $208.93 | Facility | None | $120.23 | $208.93 | $208.93 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $89.13 Median $158.49 Typical High $158.49 | Facility | 54 · Surgery only | $89.13 | $158.49 | $158.49 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $17.78 Median $31.62 Typical High $31.62 | Facility | 55 · Aftercare only | $17.78 | $31.62 | $31.62 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $147.91 Typical High $147.91 | Facility | 78 · Unplanned return to OR | $83.18 | $147.91 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $199.53 Typical High $239.88 | Professional | None | $120.23 | $199.53 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $151.36 Typical High $169.82 | Professional | 54 · Surgery only | $89.13 | $151.36 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $30.20 Typical High $33.88 | Professional | 55 · Aftercare only | $17.78 | $30.20 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $141.25 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $83.18 | $141.25 | $158.49 |
BCBS Minnesota Setting Facility Modifier None Typical Low $660.69 Median $5,128.61 Typical High $12,302.69 | Facility | None | $660.69 | $5,128.61 | $12,302.69 |
BCBS Minnesota Setting Professional Modifier None Typical Low $194.98 Median $363.08 Typical High $616.60 | Professional | None | $194.98 | $363.08 | $616.60 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $295.12 Typical High $489.78 | Professional | 54 · Surgery only | $154.88 | $295.12 | $489.78 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $72.44 Typical High $120.23 | Professional | 55 · Aftercare only | $38.90 | $72.44 | $120.23 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $309.03 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $162.18 | $309.03 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $562.34 Typical High $1,071.52 | Facility | None | $363.08 | $562.34 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $398.11 Typical High $741.31 | Professional | None | $208.93 | $398.11 | $741.31 |
Health Partners Setting Facility Modifier None Typical Low $323.59 Median $512.86 Typical High $912.01 | Facility | None | $323.59 | $512.86 | $912.01 |
Health Partners Setting Professional Modifier None Typical Low $208.93 Median $363.08 Typical High $724.44 | Professional | None | $208.93 | $363.08 | $724.44 |
Medica Setting Facility Modifier None Typical Low $234.42 Median $1,202.26 Typical High $3,467.37 | Facility | None | $234.42 | $1,202.26 | $3,467.37 |
Medica Setting Professional Modifier None Typical Low $223.87 Median $588.84 Typical High $1,621.81 | Professional | None | $223.87 | $588.84 | $1,621.81 |
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 $128.82 Median $275.42 Typical High $630.96 | Professional | None | $128.82 | $275.42 | $630.96 |
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 $60.26 Median $104.71 Typical High $104.71 | Facility | 52 · Reduced service | $60.26 | $104.71 | $104.71 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $23.99 Median $41.69 Typical High $41.69 | Facility | 53 · Discontinued | $23.99 | $41.69 | $41.69 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.02 Median $20.89 Typical High $20.89 | Facility | 56 · Pre-op care only | $12.02 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $100.00 Typical High $114.82 | Professional | 52 · Reduced service | $60.26 | $100.00 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $39.81 Typical High $45.71 | Professional | 53 · Discontinued | $23.99 | $39.81 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $19.95 Typical High $22.91 | Professional | 56 · Pre-op care only | $12.02 | $19.95 | $22.91 |
Where Minnesota sits
The same service costs 9.8 times more in Colorado than in North Dakota. 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
CO $4,589ND $469
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.