How much rates vary
Facilitymedian $1,660 · 10th to 90th $525 to $7,943Professionalmedian $1,202 · 10th to 90th $646 to $2,239
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 $524.81 Median $524.81 Typical High $524.81 | Facility | None | $524.81 | $524.81 | $524.81 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | 54 · Surgery only | $398.11 | $398.11 | $398.11 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $79.43 | Facility | 55 · Aftercare only | $79.43 | $79.43 | $79.43 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | 78 · Unplanned return to OR | $371.54 | $371.54 | $371.54 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $724.44 | Professional | None | $524.81 | $524.81 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $489.78 | Professional | 54 · Surgery only | $398.11 | $398.11 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $97.72 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $371.54 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $371.54 | $371.54 | $457.09 |
BCBS Minnesota Setting Facility Modifier None Typical Low $4,570.88 Median $7,943.28 Typical High $15,135.61 | Facility | None | $4,570.88 | $7,943.28 | $15,135.61 |
BCBS Minnesota Setting Professional Modifier None Typical Low $891.25 Median $1,202.26 Typical High $1,995.26 | Professional | None | $891.25 | $1,202.26 | $1,995.26 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $954.99 Typical High $1,584.89 | Professional | 54 · Surgery only | $707.95 | $954.99 | $1,584.89 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $239.88 Typical High $398.11 | Professional | 55 · Aftercare only | $177.83 | $239.88 | $398.11 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $1,000.00 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $741.31 | $1,000.00 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $1,445.44 Typical High $2,754.23 | Facility | None | $933.25 | $1,445.44 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,659.59 Typical High $2,630.27 | Professional | None | $1,047.13 | $1,659.59 | $2,630.27 |
Health Partners Setting Facility Modifier None Typical Low $831.76 Median $1,318.26 Typical High $2,344.23 | Facility | None | $831.76 | $1,318.26 | $2,344.23 |
Health Partners Setting Professional Modifier None Typical Low $933.25 Median $1,513.56 Typical High $2,290.87 | Professional | None | $933.25 | $1,513.56 | $2,290.87 |
Medica Setting Facility Modifier None Typical Low $977.24 Median $2,137.96 Typical High $6,760.83 | Facility | None | $977.24 | $2,137.96 | $6,760.83 |
Medica Setting Professional Modifier None Typical Low $676.08 Median $1,258.93 Typical High $5,128.61 | Professional | None | $676.08 | $1,258.93 | $5,128.61 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,511.89 Typical High $8,317.64 | Facility | None | $1,513.56 | $2,511.89 | $8,317.64 |
United Setting Professional Modifier None Typical Low $645.65 Median $1,174.90 Typical High $2,187.76 | Professional | None | $645.65 | $1,174.90 | $2,187.76 |
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 $263.03 Median $263.03 Typical High $263.03 | Facility | 52 · Reduced service | $263.03 | $263.03 | $263.03 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $104.71 | Facility | 53 · Discontinued | $104.71 | $104.71 | $104.71 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $52.48 | Facility | 56 · Pre-op care only | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $263.03 Median $263.03 Typical High $323.59 | Professional | 52 · Reduced service | $263.03 | $263.03 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $128.82 | Professional | 53 · Discontinued | $104.71 | $104.71 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $64.57 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $64.57 |
Where Minnesota sits
The same service costs 4.1 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 $7,274MT $1,783
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.