How much rates vary
Facilitymedian $5,623 · 10th to 90th $417 to $18,621Professionalmedian $2,455 · 10th to 90th $417 to $11,220
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 $416.87 Median $2,238.72 Typical High $3,801.89 | Facility | None | $416.87 | $2,238.72 | $3,801.89 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $309.03 Median $2,884.03 Typical High $2,884.03 | Facility | 54 · Surgery only | $309.03 | $2,884.03 | $2,884.03 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $61.66 Median $575.44 Typical High $575.44 | Facility | 55 · Aftercare only | $61.66 | $575.44 | $575.44 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $2,691.53 Typical High $2,691.53 | Facility | 78 · Unplanned return to OR | $288.40 | $2,691.53 | $2,691.53 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $616.60 Typical High $3,801.89 | Professional | None | $416.87 | $616.60 | $3,801.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $446.68 Typical High $2,884.03 | Professional | 54 · Surgery only | $309.03 | $446.68 | $2,884.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $91.20 Typical High $575.44 | Professional | 55 · Aftercare only | $61.66 | $91.20 | $575.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $416.87 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $288.40 | $416.87 | $2,691.53 |
BCBS Setting Facility Modifier None Typical Low $2,041.74 Median $20,417.38 Typical High $46,773.51 | Facility | None | $2,041.74 | $20,417.38 | $46,773.51 |
BCBS Setting Professional Modifier None Typical Low $812.83 Median $3,388.44 Typical High $11,220.18 | Professional | None | $812.83 | $3,388.44 | $11,220.18 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $2,630.27 Typical High $8,912.51 | Professional | 54 · Surgery only | $645.65 | $2,630.27 | $8,912.51 |
BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $691.83 Typical High $2,238.72 | Professional | 55 · Aftercare only | $162.18 | $691.83 | $2,238.72 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $2,818.38 Typical High $9,332.54 | Professional | 78 · Unplanned return to OR | $676.08 | $2,818.38 | $9,332.54 |
Cigna Setting Facility Modifier None Typical Low $6,309.57 Median $9,772.37 Typical High $18,620.87 | Facility | None | $6,309.57 | $9,772.37 | $18,620.87 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $2,884.03 Typical High $13,182.57 | Professional | None | $707.95 | $2,884.03 | $13,182.57 |
Health Partners Setting Facility Modifier None Typical Low $5,623.41 Median $9,120.11 Typical High $15,848.93 | Facility | None | $5,623.41 | $9,120.11 | $15,848.93 |
Health Partners Setting Professional Modifier None Typical Low $691.83 Median $4,786.30 Typical High $12,589.25 | Professional | None | $691.83 | $4,786.30 | $12,589.25 |
Medica Setting Facility Modifier None Typical Low $724.44 Median $4,897.79 Typical High $10,715.19 | Facility | None | $724.44 | $4,897.79 | $10,715.19 |
Medica Setting Professional Modifier None Typical Low $288.40 Median $4,897.79 Typical High $28,183.83 | Professional | None | $288.40 | $4,897.79 | $28,183.83 |
United Setting Facility Modifier None Typical Low $3,235.94 Median $5,370.32 Typical High $12,882.50 | Facility | None | $3,235.94 | $5,370.32 | $12,882.50 |
United Setting Professional Modifier None Typical Low $251.19 Median $954.99 Typical High $6,456.54 | Professional | None | $251.19 | $954.99 | $6,456.54 |
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 $204.17 Median $1,905.46 Typical High $1,905.46 | Facility | 52 · Reduced service | $204.17 | $1,905.46 | $1,905.46 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $83.18 Median $758.58 Typical High $758.58 | Facility | 53 · Discontinued | $83.18 | $758.58 | $758.58 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $41.69 Median $380.19 Typical High $380.19 | Facility | 56 · Pre-op care only | $41.69 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $302.00 Typical High $1,905.46 | Professional | 52 · Reduced service | $204.17 | $302.00 | $1,905.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $120.23 Typical High $758.58 | Professional | 53 · Discontinued | $83.18 | $120.23 | $758.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $60.26 Typical High $380.19 | Professional | 56 · Pre-op care only | $41.69 | $60.26 | $380.19 |
Where Minnesota sits
The same service costs 18.4 times more in Alabama 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
AL $30,876MT $1,679
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.