How much rates vary
Facilitymedian $2,818 · 10th to 90th $631 to $10,000Professionalmedian $2,089 · 10th to 90th $1,047 to $3,890
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 $630.96 Median $1,023.29 Typical High $1,023.29 | Facility | None | $630.96 | $1,023.29 | $1,023.29 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $758.58 | Facility | 54 · Surgery only | $758.58 | $758.58 | $758.58 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $151.36 | Facility | 55 · Aftercare only | $151.36 | $151.36 | $151.36 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $707.95 | Facility | 78 · Unplanned return to OR | $707.95 | $707.95 | $707.95 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,230.27 | Professional | None | $1,023.29 | $1,023.29 | $1,230.27 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $776.25 | Professional | 54 · Surgery only | $758.58 | $758.58 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $158.49 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $724.44 |
BCBS Minnesota Setting Facility Modifier None Typical Low $5,754.40 Median $11,481.54 Typical High $23,988.33 | Facility | None | $5,754.40 | $11,481.54 | $23,988.33 |
BCBS Minnesota Setting Professional Modifier None Typical Low $1,621.81 Median $2,137.96 Typical High $3,388.44 | Professional | None | $1,621.81 | $2,137.96 | $3,388.44 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,698.24 Typical High $2,754.23 | Professional | 54 · Surgery only | $1,288.25 | $1,698.24 | $2,754.23 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $426.58 Typical High $691.83 | Professional | 55 · Aftercare only | $323.59 | $426.58 | $691.83 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,778.28 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,778.28 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $1,698.24 Median $2,630.27 Typical High $5,011.87 | Facility | None | $1,698.24 | $2,630.27 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $2,754.23 Typical High $4,265.80 | Professional | None | $1,621.81 | $2,754.23 | $4,265.80 |
Health Partners Setting Facility Modifier None Typical Low $1,479.11 Median $2,398.83 Typical High $4,168.69 | Facility | None | $1,479.11 | $2,398.83 | $4,168.69 |
Health Partners Setting Professional Modifier None Typical Low $1,445.44 Median $2,511.89 Typical High $4,073.80 | Professional | None | $1,445.44 | $2,511.89 | $4,073.80 |
Medica Setting Facility Modifier None Typical Low $1,737.80 Median $3,630.78 Typical High $9,772.37 | Facility | None | $1,737.80 | $3,630.78 | $9,772.37 |
Medica Setting Professional Modifier None Typical Low $1,122.02 Median $2,089.30 Typical High $7,762.47 | Professional | None | $1,122.02 | $2,089.30 | $7,762.47 |
United Setting Facility Modifier None Typical Low $2,818.38 Median $4,265.80 Typical High $9,772.37 | Facility | None | $2,818.38 | $4,265.80 | $9,772.37 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,862.09 Typical High $3,801.89 | Professional | None | $1,071.52 | $1,862.09 | $3,801.89 |
7 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 $512.86 Median $512.86 Typical High $512.86 | Facility | 52 · Reduced service | $512.86 | $512.86 | $512.86 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | 53 · Discontinued | $204.17 | $204.17 | $204.17 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | 56 · Pre-op care only | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $512.86 Median $512.86 Typical High $524.81 | Professional | 52 · Reduced service | $512.86 | $512.86 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $208.93 | Professional | 53 · Discontinued | $204.17 | $204.17 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $104.71 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $104.71 |
BCBS Minnesota Setting Professional Modifier 62 · Two surgeons Typical Low $1,000.00 Median $1,288.25 Typical High $2,089.30 | Professional | 62 · Two surgeons | $1,000.00 | $1,288.25 | $2,089.30 |
Where Minnesota sits
The same service costs 5.3 times more in Vermont than in Hawaii. 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
VT $13,652HI $2,577
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.