How much rates vary
Facilitymedian $1,660 · 10th to 90th $447 to $5,129Professionalmedian $617 · 10th to 90th $282 to $1,413
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 $190.55 Median $1,548.82 Typical High $7,079.46 | Facility | None | $190.55 | $1,548.82 | $7,079.46 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $144.54 Median $331.13 Typical High $331.13 | Facility | 54 · Surgery only | $144.54 | $331.13 | $331.13 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $28.84 Median $66.07 Typical High $66.07 | Facility | 55 · Aftercare only | $28.84 | $66.07 | $66.07 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $309.03 Typical High $309.03 | Facility | 78 · Unplanned return to OR | $134.90 | $309.03 | $309.03 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $407.38 Typical High $501.19 | Professional | None | $190.55 | $407.38 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $302.00 Typical High $331.13 | Professional | 54 · Surgery only | $144.54 | $302.00 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $60.26 Typical High $66.07 | Professional | 55 · Aftercare only | $28.84 | $60.26 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $281.84 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $134.90 | $281.84 | $309.03 |
BCBS Minnesota Setting Facility Modifier None Typical Low $1,995.26 Median $3,801.89 Typical High $7,413.10 | Facility | None | $1,995.26 | $3,801.89 | $7,413.10 |
BCBS Minnesota Setting Facility Modifier 50 · Both sides Typical Low $3,890.45 Median $7,244.36 Typical High $12,882.50 | Facility | 50 · Both sides | $3,890.45 | $7,244.36 | $12,882.50 |
BCBS Minnesota Setting Professional Modifier None Typical Low $316.23 Median $707.95 Typical High $1,288.25 | Professional | None | $316.23 | $707.95 | $1,288.25 |
BCBS Minnesota Setting Professional Modifier 50 · Both sides Typical Low $478.63 Median $1,047.13 Typical High $1,949.84 | Professional | 50 · Both sides | $478.63 | $1,047.13 | $1,949.84 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $562.34 Typical High $1,023.29 | Professional | 54 · Surgery only | $257.04 | $562.34 | $1,023.29 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $141.25 Typical High $257.04 | Professional | 55 · Aftercare only | $66.07 | $141.25 | $257.04 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $588.84 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $269.15 | $588.84 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,148.15 Typical High $2,187.76 | Facility | None | $758.58 | $1,148.15 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $724.44 Typical High $1,548.82 | Professional | None | $338.84 | $724.44 | $1,548.82 |
Health Partners Setting Facility Modifier None Typical Low $645.65 Median $1,071.52 Typical High $1,819.70 | Facility | None | $645.65 | $1,071.52 | $1,819.70 |
Health Partners Setting Professional Modifier None Typical Low $316.23 Median $660.69 Typical High $1,479.11 | Professional | None | $316.23 | $660.69 | $1,479.11 |
Medica Setting Facility Modifier None Typical Low $467.74 Median $1,819.70 Typical High $4,677.35 | Facility | None | $467.74 | $1,819.70 | $4,677.35 |
Medica Setting Facility Modifier 50 · Both sides Typical Low $1,584.89 Median $4,073.80 Typical High $5,888.44 | Facility | 50 · Both sides | $1,584.89 | $4,073.80 | $5,888.44 |
Medica Setting Professional Modifier None Typical Low $457.09 Median $1,000.00 Typical High $3,311.31 | Professional | None | $457.09 | $1,000.00 | $3,311.31 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,511.89 Typical High $5,888.44 | Facility | None | $1,513.56 | $2,511.89 | $5,888.44 |
United Setting Professional Modifier None Typical Low $269.15 Median $588.84 Typical High $1,318.26 | Professional | None | $269.15 | $588.84 | $1,318.26 |
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 $95.50 Median $223.87 Typical High $223.87 | Facility | 52 · Reduced service | $95.50 | $223.87 | $223.87 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $38.02 Median $89.13 Typical High $89.13 | Facility | 53 · Discontinued | $38.02 | $89.13 | $89.13 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $19.05 Median $44.67 Typical High $44.67 | Facility | 56 · Pre-op care only | $19.05 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $204.17 Typical High $223.87 | Professional | 52 · Reduced service | $95.50 | $204.17 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $81.28 Typical High $89.13 | Professional | 53 · Discontinued | $38.02 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $40.74 Typical High $44.67 | Professional | 56 · Pre-op care only | $19.05 | $40.74 | $44.67 |
Where Minnesota sits
The same service costs 4.6 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 $4,720MT $1,020
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.