How much rates vary
Facilitymedian $871 · 10th to 90th $195 to $4,365Professionalmedian $537 · 10th to 90th $257 to $1,072
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 $194.98 Median $354.81 Typical High $354.81 | Facility | None | $194.98 | $354.81 | $354.81 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $147.91 Median $263.03 Typical High $263.03 | Facility | 54 · Surgery only | $147.91 | $263.03 | $263.03 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $29.51 Median $52.48 Typical High $52.48 | Facility | 55 · Aftercare only | $29.51 | $52.48 | $52.48 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $245.47 Typical High $245.47 | Facility | 78 · Unplanned return to OR | $138.04 | $245.47 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $295.12 Typical High $354.81 | Professional | None | $194.98 | $295.12 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $239.88 Typical High $263.03 | Professional | 54 · Surgery only | $147.91 | $239.88 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $47.86 Typical High $52.48 | Professional | 55 · Aftercare only | $29.51 | $47.86 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $223.87 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $138.04 | $223.87 | $245.47 |
BCBS Minnesota Setting Facility Modifier None Typical Low $1,047.13 Median $3,801.89 Typical High $8,912.51 | Facility | None | $1,047.13 | $3,801.89 | $8,912.51 |
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 None Typical Low $295.12 Median $562.34 Typical High $954.99 | Professional | None | $295.12 | $562.34 | $954.99 |
BCBS Minnesota Setting Professional Modifier 50 · Both sides Typical Low $446.68 Median $851.14 Typical High $1,412.54 | Professional | 50 · Both sides | $446.68 | $851.14 | $1,412.54 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $446.68 Typical High $758.58 | Professional | 54 · Surgery only | $239.88 | $446.68 | $758.58 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $112.20 Typical High $190.55 | Professional | 55 · Aftercare only | $58.88 | $112.20 | $190.55 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $467.74 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $251.19 | $467.74 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $851.14 Typical High $1,621.81 | Facility | None | $549.54 | $851.14 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $630.96 Typical High $1,202.26 | Professional | None | $309.03 | $630.96 | $1,202.26 |
Health Partners Setting Facility Modifier None Typical Low $489.78 Median $794.33 Typical High $1,380.38 | Facility | None | $489.78 | $794.33 | $1,380.38 |
Health Partners Setting Professional Modifier None Typical Low $302.00 Median $562.34 Typical High $1,148.15 | Professional | None | $302.00 | $562.34 | $1,148.15 |
Medica Setting Facility Modifier None Typical Low $346.74 Median $1,659.59 Typical High $4,786.30 | Facility | None | $346.74 | $1,659.59 | $4,786.30 |
Medica Setting Professional Modifier None Typical Low $363.08 Median $645.65 Typical High $2,454.71 | Professional | None | $363.08 | $645.65 | $2,454.71 |
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 $234.42 Median $457.09 Typical High $1,023.29 | Professional | None | $234.42 | $457.09 | $1,023.29 |
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 $97.72 Median $177.83 Typical High $177.83 | Facility | 52 · Reduced service | $97.72 | $177.83 | $177.83 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $38.90 Median $70.79 Typical High $70.79 | Facility | 53 · Discontinued | $38.90 | $70.79 | $70.79 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $19.50 Median $35.48 Typical High $35.48 | Facility | 56 · Pre-op care only | $19.50 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $97.72 Median $162.18 Typical High $177.83 | Professional | 52 · Reduced service | $97.72 | $162.18 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $64.57 Typical High $70.79 | Professional | 53 · Discontinued | $38.90 | $64.57 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $32.36 Typical High $35.48 | Professional | 56 · Pre-op care only | $19.50 | $32.36 | $35.48 |
Where Minnesota sits
The same service costs 6.3 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 $4,654MT $736
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.