How much rates vary
Facilitymedian $437 · 10th to 90th $102 to $5,888Professionalmedian $309 · 10th to 90th $155 to $575
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 $102.33 Median $154.88 Typical High $154.88 | Facility | None | $102.33 | $154.88 | $154.88 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $77.62 Median $114.82 Typical High $114.82 | Facility | 54 · Surgery only | $77.62 | $114.82 | $114.82 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $15.49 Median $22.91 Typical High $22.91 | Facility | 55 · Aftercare only | $15.49 | $22.91 | $22.91 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $107.15 Typical High $107.15 | Facility | 78 · Unplanned return to OR | $72.44 | $107.15 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $141.25 Typical High $158.49 | Professional | None | $102.33 | $141.25 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $112.20 Typical High $114.82 | Professional | 54 · Surgery only | $77.62 | $112.20 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $22.39 Typical High $22.91 | Professional | 55 · Aftercare only | $15.49 | $22.39 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $104.71 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $72.44 | $104.71 | $107.15 |
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 $186.21 Median $302.00 Typical High $512.86 | Professional | None | $186.21 | $302.00 | $512.86 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $239.88 Typical High $416.87 | Professional | 54 · Surgery only | $147.91 | $239.88 | $416.87 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $61.66 Typical High $102.33 | Professional | 55 · Aftercare only | $37.15 | $61.66 | $102.33 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $257.04 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $154.88 | $257.04 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $416.87 Typical High $812.83 | Facility | None | $269.15 | $416.87 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $398.11 Typical High $707.95 | Professional | None | $245.47 | $398.11 | $707.95 |
Health Partners Setting Facility Modifier None Typical Low $239.88 Median $389.05 Typical High $676.08 | Facility | None | $239.88 | $389.05 | $676.08 |
Health Partners Setting Professional Modifier None Typical Low $208.93 Median $363.08 Typical High $660.69 | Professional | None | $208.93 | $363.08 | $660.69 |
Medica Setting Facility Modifier None Typical Low $190.55 Median $1,621.81 Typical High $4,365.16 | Facility | None | $190.55 | $1,621.81 | $4,365.16 |
Medica Setting Professional Modifier None Typical Low $173.78 Median $389.05 Typical High $851.14 | Professional | None | $173.78 | $389.05 | $851.14 |
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 $147.91 Median $257.04 Typical High $537.03 | Professional | None | $147.91 | $257.04 | $537.03 |
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 $51.29 Median $77.62 Typical High $77.62 | Facility | 52 · Reduced service | $51.29 | $77.62 | $77.62 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $20.42 Median $30.90 Typical High $30.90 | Facility | 53 · Discontinued | $20.42 | $30.90 | $30.90 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.23 Median $15.49 Typical High $15.49 | Facility | 56 · Pre-op care only | $10.23 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $51.29 Median $74.13 Typical High $77.62 | Professional | 52 · Reduced service | $51.29 | $74.13 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $29.51 Typical High $30.90 | Professional | 53 · Discontinued | $20.42 | $29.51 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $14.79 Typical High $15.49 | Professional | 56 · Pre-op care only | $10.23 | $14.79 | $15.49 |
Where Minnesota sits
The same service costs 3.6 times more in Wisconsin than in Texas. 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.
Minnesota· 3rd of 51
$316
WI $468TX $129
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.