How much rates vary
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 $1,000.00 Median $1,000.00 Typical High $1,000.00 | Facility | None | $1,000.00 | $1,000.00 | $1,000.00 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $741.31 | Facility | 54 · Surgery only | $741.31 | $741.31 | $741.31 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $147.91 | Facility | 55 · Aftercare only | $147.91 | $147.91 | $147.91 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $691.83 | Facility | 78 · Unplanned return to OR | $691.83 | $691.83 | $691.83 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,148.15 | Professional | None | $1,000.00 | $1,000.00 | $1,148.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $831.76 | Professional | 54 · Surgery only | $741.31 | $741.31 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $165.96 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $776.25 |
BCBS Minnesota Setting Facility Modifier None Typical Low $5,495.41 Median $11,220.18 Typical High $22,387.21 | Facility | None | $5,495.41 | $11,220.18 | $22,387.21 |
BCBS Minnesota Setting Professional Modifier None Typical Low $1,548.82 Median $2,089.30 Typical High $3,630.78 | Professional | None | $1,548.82 | $2,089.30 | $3,630.78 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,659.59 Typical High $2,884.03 | Professional | 54 · Surgery only | $1,230.27 | $1,659.59 | $2,884.03 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $416.87 Typical High $707.95 | Professional | 55 · Aftercare only | $309.03 | $416.87 | $707.95 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,737.80 Typical High $3,019.95 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,737.80 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $1,659.59 Median $2,570.40 Typical High $4,897.79 | Facility | None | $1,659.59 | $2,570.40 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $2,951.21 Typical High $4,677.35 | Professional | None | $1,905.46 | $2,951.21 | $4,677.35 |
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 $1,659.59 Median $2,691.53 Typical High $4,073.80 | Professional | None | $1,659.59 | $2,691.53 | $4,073.80 |
Medica Setting Facility Modifier None Typical Low $1,698.24 Median $3,630.78 Typical High $9,772.37 | Facility | None | $1,698.24 | $3,630.78 | $9,772.37 |
Medica Setting Professional Modifier None Typical Low $1,202.26 Median $2,238.72 Typical High $7,585.78 | Professional | None | $1,202.26 | $2,238.72 | $7,585.78 |
United Setting Facility Modifier None Typical Low $2,818.38 Median $4,265.80 Typical High $11,220.18 | Facility | None | $2,818.38 | $4,265.80 | $11,220.18 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $2,089.30 Typical High $3,890.45 | Professional | None | $1,148.15 | $2,089.30 | $3,890.45 |
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 $501.19 Median $501.19 Typical High $501.19 | Facility | 52 · Reduced service | $501.19 | $501.19 | $501.19 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $199.53 | Facility | 53 · Discontinued | $199.53 | $199.53 | $199.53 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | 56 · Pre-op care only | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $501.19 Median $501.19 Typical High $549.54 | Professional | 52 · Reduced service | $501.19 | $501.19 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $218.78 | Professional | 53 · Discontinued | $199.53 | $199.53 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $109.65 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $109.65 |
BCBS Minnesota Setting Facility Modifier 50 · Both sides Typical Low $11,748.98 Median $21,379.62 Typical High $38,904.51 | Facility | 50 · Both sides | $11,748.98 | $21,379.62 | $38,904.51 |
BCBS Minnesota Setting Professional Modifier 50 · Both sides Typical Low $2,290.87 Median $3,090.30 Typical High $5,370.32 | Professional | 50 · Both sides | $2,290.87 | $3,090.30 | $5,370.32 |
Where Minnesota sits
The same service costs 7.2 times more in Oklahoma than in Utah. 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.
Minnesota· 6th of 51
$2,455
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.