How much rates vary
Facilitymedian $316 · 10th to 90th $78 to $3,981Professionalmedian $174 · 10th to 90th $83 to $331
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 $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $58.88 Median $58.88 Typical High $58.88 | Facility | 54 · Surgery only | $58.88 | $58.88 | $58.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $11.75 Median $11.75 Typical High $11.75 | Facility | 55 · Aftercare only | $11.75 | $11.75 | $11.75 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | 78 · Unplanned return to OR | $54.95 | $54.95 | $54.95 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $93.33 | Professional | None | $77.62 | $77.62 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $58.88 Typical High $66.07 | Professional | 54 · Surgery only | $58.88 | $58.88 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $11.75 Typical High $13.18 | Professional | 55 · Aftercare only | $11.75 | $11.75 | $13.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $54.95 Median $54.95 Typical High $61.66 | Professional | 78 · Unplanned return to OR | $54.95 | $54.95 | $61.66 |
BCBS Minnesota Setting Facility Modifier None Typical Low $1,071.52 Median $3,548.13 Typical High $7,762.47 | Facility | None | $1,071.52 | $3,548.13 | $7,762.47 |
BCBS Minnesota Setting Professional Modifier None Typical Low $120.23 Median $162.18 Typical High $275.42 | Professional | None | $120.23 | $162.18 | $275.42 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $131.83 Typical High $218.78 | Professional | 54 · Surgery only | $97.72 | $131.83 | $218.78 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $33.11 Typical High $54.95 | Professional | 55 · Aftercare only | $23.99 | $33.11 | $54.95 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $138.04 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $102.33 | $138.04 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $199.53 Typical High $380.19 | Facility | None | $128.82 | $199.53 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $229.09 Typical High $363.08 | Professional | None | $147.91 | $229.09 | $363.08 |
Health Partners Setting Facility Modifier None Typical Low $114.82 Median $186.21 Typical High $323.59 | Facility | None | $114.82 | $186.21 | $323.59 |
Health Partners Setting Professional Modifier None Typical Low $128.82 Median $208.93 Typical High $316.23 | Professional | None | $128.82 | $208.93 | $316.23 |
Medica Setting Facility Modifier None Typical Low $138.04 Median $1,258.93 Typical High $3,981.07 | Facility | None | $138.04 | $1,258.93 | $3,981.07 |
Medica Setting Professional Modifier None Typical Low $95.50 Median $173.78 Typical High $660.69 | Professional | None | $95.50 | $173.78 | $660.69 |
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 $89.13 Median $162.18 Typical High $323.59 | Professional | None | $89.13 | $162.18 | $323.59 |
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 $38.90 Median $38.90 Typical High $38.90 | Facility | 52 · Reduced service | $38.90 | $38.90 | $38.90 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $15.85 Median $15.85 Typical High $15.85 | Facility | 53 · Discontinued | $15.85 | $15.85 | $15.85 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.76 Typical High $7.76 | Facility | 56 · Pre-op care only | $7.76 | $7.76 | $7.76 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $38.90 Typical High $43.65 | Professional | 52 · Reduced service | $38.90 | $38.90 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $15.85 Typical High $17.38 | Professional | 53 · Discontinued | $15.85 | $15.85 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.76 Typical High $8.71 | Professional | 56 · Pre-op care only | $7.76 | $7.76 | $8.71 |
BCBS Minnesota Setting Professional Modifier 50 · Both sides Typical Low $181.97 Median $245.47 Typical High $416.87 | Professional | 50 · Both sides | $181.97 | $245.47 | $416.87 |
Where Minnesota sits
The same service costs 18.4 times more in Colorado 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
CO $4,483MT $243
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.