How much rates vary
Facilitymedian $2,138 · 10th to 90th $776 to $10,715Professionalmedian $1,660 · 10th to 90th $891 to $3,236
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 $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $588.84 | Facility | 54 · Surgery only | $588.84 | $588.84 | $588.84 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | 55 · Aftercare only | $117.49 | $117.49 | $117.49 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | 78 · Unplanned return to OR | $549.54 | $549.54 | $549.54 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $954.99 | Professional | None | $776.25 | $776.25 | $954.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $676.08 | Professional | 54 · Surgery only | $588.84 | $588.84 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $134.90 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $630.96 |
BCBS Minnesota Setting Facility Modifier None Typical Low $6,760.83 Median $12,589.25 Typical High $25,118.86 | Facility | None | $6,760.83 | $12,589.25 | $25,118.86 |
BCBS Minnesota Setting Professional Modifier None Typical Low $1,230.27 Median $1,659.59 Typical High $2,754.23 | Professional | None | $1,230.27 | $1,659.59 | $2,754.23 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,318.26 Typical High $2,187.76 | Professional | 54 · Surgery only | $977.24 | $1,318.26 | $2,187.76 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $331.13 Typical High $549.54 | Professional | 55 · Aftercare only | $245.47 | $331.13 | $549.54 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,380.38 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,380.38 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $1,995.26 Typical High $3,801.89 | Facility | None | $1,288.25 | $1,995.26 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $2,290.87 Typical High $3,630.78 | Professional | None | $1,445.44 | $2,290.87 | $3,630.78 |
Health Partners Setting Facility Modifier None Typical Low $1,148.15 Median $1,819.70 Typical High $3,235.94 | Facility | None | $1,148.15 | $1,819.70 | $3,235.94 |
Health Partners Setting Professional Modifier None Typical Low $1,288.25 Median $2,089.30 Typical High $3,162.28 | Professional | None | $1,288.25 | $2,089.30 | $3,162.28 |
Medica Setting Facility Modifier None Typical Low $1,348.96 Median $2,754.23 Typical High $7,762.47 | Facility | None | $1,348.96 | $2,754.23 | $7,762.47 |
Medica Setting Professional Modifier None Typical Low $912.01 Median $1,737.80 Typical High $5,888.44 | Professional | None | $912.01 | $1,737.80 | $5,888.44 |
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 $891.25 Median $1,621.81 Typical High $3,235.94 | Professional | None | $891.25 | $1,621.81 | $3,235.94 |
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 $389.05 Median $389.05 Typical High $389.05 | Facility | 52 · Reduced service | $389.05 | $389.05 | $389.05 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $154.88 | Facility | 53 · Discontinued | $154.88 | $154.88 | $154.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | 56 · Pre-op care only | $77.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $389.05 Median $389.05 Typical High $446.68 | Professional | 52 · Reduced service | $389.05 | $389.05 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $177.83 | Professional | 53 · Discontinued | $154.88 | $154.88 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $89.13 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $89.13 |
Where Minnesota sits
The same service costs 5.0 times more in Oklahoma than in Hawaii. 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
OK $9,757HI $1,932
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.