How much rates vary
Facilitymedian $813 · 10th to 90th $145 to $7,413Professionalmedian $263 · 10th to 90th $145 to $537
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 $144.54 Median $144.54 Typical High $7,413.10 | Facility | None | $144.54 | $144.54 | $7,413.10 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | 54 · Surgery only | $109.65 | $109.65 | $109.65 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $21.88 Median $21.88 Typical High $21.88 | Facility | 55 · Aftercare only | $21.88 | $21.88 | $21.88 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | 78 · Unplanned return to OR | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $199.53 | Professional | None | $144.54 | $144.54 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $109.65 Typical High $120.23 | Professional | 54 · Surgery only | $109.65 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $21.88 Typical High $23.99 | Professional | 55 · Aftercare only | $21.88 | $21.88 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $102.33 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $102.33 | $102.33 | $112.20 |
BCBS Minnesota Setting Facility Modifier None Typical Low $776.25 Median $3,715.35 Typical High $8,912.51 | Facility | None | $776.25 | $3,715.35 | $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 $199.53 Median $257.04 Typical High $457.09 | Professional | None | $199.53 | $257.04 | $457.09 |
BCBS Minnesota Setting Professional Modifier 50 · Both sides Typical Low $302.00 Median $380.19 Typical High $676.08 | Professional | 50 · Both sides | $302.00 | $380.19 | $676.08 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $204.17 Typical High $363.08 | Professional | 54 · Surgery only | $158.49 | $204.17 | $363.08 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $51.29 Typical High $87.10 | Professional | 55 · Aftercare only | $39.81 | $51.29 | $87.10 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $213.80 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $165.96 | $213.80 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $346.74 Typical High $660.69 | Facility | None | $223.87 | $346.74 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $338.84 Typical High $575.44 | Professional | None | $213.80 | $338.84 | $575.44 |
Health Partners Setting Facility Modifier None Typical Low $199.53 Median $323.59 Typical High $562.34 | Facility | None | $199.53 | $323.59 | $562.34 |
Health Partners Setting Professional Modifier None Typical Low $199.53 Median $316.23 Typical High $537.03 | Professional | None | $199.53 | $316.23 | $537.03 |
Medica Setting Facility Modifier None Typical Low $257.04 Median $2,137.96 Typical High $5,754.40 | Facility | None | $257.04 | $2,137.96 | $5,754.40 |
Medica Setting Professional Modifier None Typical Low $151.36 Median $257.04 Typical High $1,071.52 | Professional | None | $151.36 | $257.04 | $1,071.52 |
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 $151.36 Median $245.47 Typical High $478.63 | Professional | None | $151.36 | $245.47 | $478.63 |
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 $72.44 Median $72.44 Typical High $72.44 | Facility | 52 · Reduced service | $72.44 | $72.44 | $72.44 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $28.84 | Facility | 53 · Discontinued | $28.84 | $28.84 | $28.84 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $14.45 | Facility | 56 · Pre-op care only | $14.45 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $72.44 Median $72.44 Typical High $81.28 | Professional | 52 · Reduced service | $72.44 | $72.44 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $32.36 | Professional | 53 · Discontinued | $28.84 | $28.84 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $16.22 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $16.22 |
Where Minnesota sits
The same service costs 11.0 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 $4,556MT $413
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.