How much rates vary
Facilitymedian $1,514 · 10th to 90th $490 to $5,012Professionalmedian $1,096 · 10th to 90th $589 to $1,995
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 $489.78 Median $630.96 Typical High $630.96 | Facility | None | $489.78 | $630.96 | $630.96 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $363.08 Median $467.74 Typical High $467.74 | Facility | 54 · Surgery only | $363.08 | $467.74 | $467.74 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $72.44 Median $95.50 Typical High $95.50 | Facility | 55 · Aftercare only | $72.44 | $95.50 | $95.50 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $436.52 Typical High $436.52 | Facility | 78 · Unplanned return to OR | $338.84 | $436.52 | $436.52 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $588.84 Typical High $630.96 | Professional | None | $489.78 | $588.84 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $467.74 Typical High $467.74 | Professional | 54 · Surgery only | $363.08 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $93.33 Typical High $95.50 | Professional | 55 · Aftercare only | $72.44 | $93.33 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $436.52 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $338.84 | $436.52 | $436.52 |
BCBS Minnesota Setting Facility Modifier None Typical Low $2,454.71 Median $4,466.84 Typical High $8,912.51 | Facility | None | $2,454.71 | $4,466.84 | $8,912.51 |
BCBS Minnesota Setting Professional Modifier None Typical Low $741.31 Median $1,122.02 Typical High $1,819.70 | Professional | None | $741.31 | $1,122.02 | $1,819.70 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $912.01 Typical High $1,445.44 | Professional | 54 · Surgery only | $588.84 | $912.01 | $1,445.44 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $223.87 Typical High $346.74 | Professional | 55 · Aftercare only | $147.91 | $223.87 | $346.74 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $954.99 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $616.60 | $954.99 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $977.24 Median $1,513.56 Typical High $2,884.03 | Facility | None | $977.24 | $1,513.56 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $1,318.26 Typical High $2,290.87 | Professional | None | $758.58 | $1,318.26 | $2,290.87 |
Health Partners Setting Facility Modifier None Typical Low $870.96 Median $1,445.44 Typical High $2,454.71 | Facility | None | $870.96 | $1,445.44 | $2,454.71 |
Health Partners Setting Professional Modifier None Typical Low $758.58 Median $1,230.27 Typical High $2,089.30 | Professional | None | $758.58 | $1,230.27 | $2,089.30 |
Medica Setting Facility Modifier None Typical Low $794.33 Median $1,737.80 Typical High $5,011.87 | Facility | None | $794.33 | $1,737.80 | $5,011.87 |
Medica Setting Professional Modifier None Typical Low $660.69 Median $1,096.48 Typical High $4,365.16 | Professional | None | $660.69 | $1,096.48 | $4,365.16 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,511.89 Typical High $6,456.54 | Facility | None | $1,513.56 | $2,511.89 | $6,456.54 |
United Setting Professional Modifier None Typical Low $537.03 Median $912.01 Typical High $1,995.26 | Professional | None | $537.03 | $912.01 | $1,995.26 |
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 $239.88 Median $316.23 Typical High $316.23 | Facility | 52 · Reduced service | $239.88 | $316.23 | $316.23 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $97.72 Median $125.89 Typical High $125.89 | Facility | 53 · Discontinued | $97.72 | $125.89 | $125.89 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $48.98 Median $63.10 Typical High $63.10 | Facility | 56 · Pre-op care only | $48.98 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $239.88 Median $316.23 Typical High $316.23 | Professional | 52 · Reduced service | $239.88 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $97.72 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $48.98 | $63.10 | $63.10 |
BCBS Minnesota Setting Facility Modifier 50 · Both sides Typical Low $4,677.35 Median $8,511.38 Typical High $15,488.17 | Facility | 50 · Both sides | $4,677.35 | $8,511.38 | $15,488.17 |
BCBS Minnesota Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,698.24 Typical High $2,691.53 | Professional | 50 · Both sides | $1,096.48 | $1,698.24 | $2,691.53 |
Where Minnesota sits
The same service costs 4.0 times more in Oklahoma than in West Virginia. 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 $5,056WV $1,262
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.