How much rates vary
Facilitymedian $2,239 · 10th to 90th $631 to $8,318Professionalmedian $1,349 · 10th to 90th $724 to $2,630
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 $630.96 Median $630.96 Typical High $6,606.93 | Facility | None | $630.96 | $630.96 | $6,606.93 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $478.63 | Facility | 54 · Surgery only | $478.63 | $478.63 | $478.63 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | 55 · Aftercare only | $95.50 | $95.50 | $95.50 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $446.68 | Facility | 78 · Unplanned return to OR | $446.68 | $446.68 | $446.68 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $776.25 | Professional | None | $630.96 | $630.96 | $776.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $549.54 | Professional | 54 · Surgery only | $478.63 | $478.63 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $109.65 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $512.86 |
BCBS Minnesota Setting Facility Modifier None Typical Low $3,467.37 Median $9,549.93 Typical High $21,877.62 | Facility | None | $3,467.37 | $9,549.93 | $21,877.62 |
BCBS Minnesota Setting Professional Modifier None Typical Low $977.24 Median $1,348.96 Typical High $2,238.72 | Professional | None | $977.24 | $1,348.96 | $2,238.72 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $1,071.52 Typical High $1,778.28 | Professional | 54 · Surgery only | $794.33 | $1,071.52 | $1,778.28 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $269.15 Typical High $446.68 | Professional | 55 · Aftercare only | $194.98 | $269.15 | $446.68 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $1,122.02 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $831.76 | $1,122.02 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $1,047.13 Median $1,621.81 Typical High $3,090.30 | Facility | None | $1,047.13 | $1,621.81 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,862.09 Typical High $2,951.21 | Professional | None | $1,174.90 | $1,862.09 | $2,951.21 |
Health Partners Setting Facility Modifier None Typical Low $933.25 Median $1,479.11 Typical High $2,570.40 | Facility | None | $933.25 | $1,479.11 | $2,570.40 |
Health Partners Setting Professional Modifier None Typical Low $1,047.13 Median $1,698.24 Typical High $2,570.40 | Professional | None | $1,047.13 | $1,698.24 | $2,570.40 |
Medica Setting Facility Modifier None Typical Low $1,096.48 Median $2,818.38 Typical High $9,332.54 | Facility | None | $1,096.48 | $2,818.38 | $9,332.54 |
Medica Setting Professional Modifier None Typical Low $758.58 Median $1,412.54 Typical High $19,054.61 | Professional | None | $758.58 | $1,412.54 | $19,054.61 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $3,090.30 Typical High $10,000.00 | Facility | None | $1,995.26 | $3,090.30 | $10,000.00 |
United Setting Professional Modifier None Typical Low $707.95 Median $1,318.26 Typical High $2,630.27 | Professional | None | $707.95 | $1,318.26 | $2,630.27 |
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 $316.23 Median $316.23 Typical High $316.23 | Facility | 52 · Reduced service | $316.23 | $316.23 | $316.23 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | 53 · Discontinued | $125.89 | $125.89 | $125.89 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | 56 · Pre-op care only | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $316.23 Median $316.23 Typical High $363.08 | Professional | 52 · Reduced service | $316.23 | $316.23 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $144.54 | Professional | 53 · Discontinued | $125.89 | $125.89 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $72.44 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $72.44 |
BCBS Minnesota Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $831.76 Typical High $1,380.38 | Professional | 62 · Two surgeons | $616.60 | $831.76 | $1,380.38 |
Where Minnesota sits
The same service costs 5.1 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 $10,170MT $2,000
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.