How much rates vary
Facilitymedian $2,089 · 10th to 90th $851 to $5,888Professionalmedian $1,514 · 10th to 90th $851 to $3,090
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 $851.14 Median $851.14 Typical High $851.14 | Facility | None | $851.14 | $851.14 | $851.14 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | 54 · Surgery only | $630.96 | $630.96 | $630.96 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | 55 · Aftercare only | $125.89 | $125.89 | $125.89 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $588.84 | Facility | 78 · Unplanned return to OR | $588.84 | $588.84 | $588.84 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $977.24 | Professional | None | $851.14 | $851.14 | $977.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $707.95 | Professional | 54 · Surgery only | $630.96 | $630.96 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $141.25 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $660.69 |
BCBS Minnesota Setting Facility Modifier None Typical Low $2,187.76 Median $4,073.80 Typical High $8,709.64 | Facility | None | $2,187.76 | $4,073.80 | $8,709.64 |
BCBS Minnesota Setting Professional Modifier None Typical Low $1,174.90 Median $1,479.11 Typical High $2,630.27 | Professional | None | $1,174.90 | $1,479.11 | $2,630.27 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,174.90 Typical High $2,089.30 | Professional | 54 · Surgery only | $933.25 | $1,174.90 | $2,089.30 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $295.12 Typical High $501.19 | Professional | 55 · Aftercare only | $234.42 | $295.12 | $501.19 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,258.93 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $977.24 | $1,258.93 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $2,041.74 Typical High $3,890.45 | Facility | None | $1,318.26 | $2,041.74 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,995.26 Typical High $3,388.44 | Professional | None | $1,174.90 | $1,995.26 | $3,388.44 |
Health Partners Setting Facility Modifier None Typical Low $1,174.90 Median $1,862.09 Typical High $3,311.31 | Facility | None | $1,174.90 | $1,862.09 | $3,311.31 |
Health Partners Setting Professional Modifier None Typical Low $1,148.15 Median $1,862.09 Typical High $3,162.28 | Professional | None | $1,148.15 | $1,862.09 | $3,162.28 |
Medica Setting Facility Modifier None Typical Low $1,380.38 Median $2,187.76 Typical High $5,495.41 | Facility | None | $1,380.38 | $2,187.76 | $5,495.41 |
Medica Setting Professional Modifier None Typical Low $891.25 Median $1,479.11 Typical High $5,888.44 | Professional | None | $891.25 | $1,479.11 | $5,888.44 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,511.89 Typical High $6,309.57 | Facility | None | $1,513.56 | $2,511.89 | $6,309.57 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,412.54 Typical High $2,754.23 | Professional | None | $870.96 | $1,412.54 | $2,754.23 |
8 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 $426.58 Median $426.58 Typical High $426.58 | Facility | 52 · Reduced service | $426.58 | $426.58 | $426.58 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $169.82 | Facility | 53 · Discontinued | $169.82 | $169.82 | $169.82 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | 56 · Pre-op care only | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $426.58 Median $426.58 Typical High $467.74 | Professional | 52 · Reduced service | $426.58 | $426.58 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $186.21 | Professional | 53 · Discontinued | $169.82 | $169.82 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $93.33 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $93.33 |
BCBS Minnesota Setting Facility Modifier 50 · Both sides Typical Low $4,570.88 Median $8,511.38 Typical High $15,135.61 | Facility | 50 · Both sides | $4,570.88 | $8,511.38 | $15,135.61 |
BCBS Minnesota Setting Professional Modifier 50 · Both sides Typical Low $1,737.80 Median $2,238.72 Typical High $3,981.07 | Professional | 50 · Both sides | $1,737.80 | $2,238.72 | $3,981.07 |
Where Minnesota sits
The same service costs 3.7 times more in Oklahoma than in Mississippi. 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
OK $7,181MS $1,948
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.