How much rates vary
Facilitymedian $1,514 · 10th to 90th $166 to $6,310Professionalmedian $389 · 10th to 90th $204 to $724
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 $165.96 Median $165.96 Typical High $4,897.79 | Facility | None | $165.96 | $165.96 | $4,897.79 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | 54 · Surgery only | $125.89 | $125.89 | $125.89 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $25.12 Median $25.12 Typical High $25.12 | Facility | 55 · Aftercare only | $25.12 | $25.12 | $25.12 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | 78 · Unplanned return to OR | $117.49 | $117.49 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $218.78 | Professional | None | $165.96 | $165.96 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $125.89 Typical High $154.88 | Professional | 54 · Surgery only | $125.89 | $125.89 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $25.12 Typical High $30.90 | Professional | 55 · Aftercare only | $25.12 | $25.12 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $117.49 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $117.49 | $117.49 | $144.54 |
BCBS Minnesota Setting Facility Modifier None Typical Low $4,168.69 Median $6,918.31 Typical High $13,803.84 | Facility | None | $4,168.69 | $6,918.31 | $13,803.84 |
BCBS Minnesota Setting Professional Modifier None Typical Low $275.42 Median $380.19 Typical High $645.65 | Professional | None | $275.42 | $380.19 | $645.65 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $302.00 Typical High $512.86 | Professional | 54 · Surgery only | $223.87 | $302.00 | $512.86 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $75.86 Typical High $125.89 | Professional | 55 · Aftercare only | $56.23 | $75.86 | $125.89 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $316.23 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $234.42 | $316.23 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $457.09 Typical High $870.96 | Facility | None | $295.12 | $457.09 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $524.81 Typical High $831.76 | Professional | None | $331.13 | $524.81 | $831.76 |
Health Partners Setting Facility Modifier None Typical Low $257.04 Median $416.87 Typical High $724.44 | Facility | None | $257.04 | $416.87 | $724.44 |
Health Partners Setting Professional Modifier None Typical Low $295.12 Median $467.74 Typical High $724.44 | Professional | None | $295.12 | $467.74 | $724.44 |
Medica Setting Facility Modifier None Typical Low $309.03 Median $2,187.76 Typical High $6,760.83 | Facility | None | $309.03 | $2,187.76 | $6,760.83 |
Medica Setting Professional Modifier None Typical Low $213.80 Median $398.11 Typical High $1,862.09 | Professional | None | $213.80 | $398.11 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,511.89 Typical High $8,128.31 | Facility | None | $1,513.56 | $2,511.89 | $8,128.31 |
United Setting Professional Modifier None Typical Low $204.17 Median $371.54 Typical High $691.83 | Professional | None | $204.17 | $371.54 | $691.83 |
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 $83.18 Median $83.18 Typical High $83.18 | Facility | 52 · Reduced service | $83.18 | $83.18 | $83.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $33.11 Median $33.11 Typical High $33.11 | Facility | 53 · Discontinued | $33.11 | $33.11 | $33.11 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $16.60 Median $16.60 Typical High $16.60 | Facility | 56 · Pre-op care only | $16.60 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $83.18 Median $83.18 Typical High $102.33 | Professional | 52 · Reduced service | $83.18 | $83.18 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $33.11 Typical High $40.74 | Professional | 53 · Discontinued | $33.11 | $33.11 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $16.60 Typical High $20.42 | Professional | 56 · Pre-op care only | $16.60 | $16.60 | $20.42 |
Where Minnesota sits
The same service costs 8.1 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 $4,634MT $570
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.