How much rates vary
Facilitymedian $512,861 · 10th to 90th $457,088 to $1,258,925Professionalmedian $501,187 · 10th to 90th $426,580 to $616,595
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 $512,861.38 Median $512,861.38 Typical High $512,861.38 | Facility | None | $512,861.38 | $512,861.38 | $512,861.38 |
Aetna Setting Professional Modifier None Typical Low $512,861.38 Median $512,861.38 Typical High $524,807.46 | Professional | None | $512,861.38 | $512,861.38 | $524,807.46 |
BCBS Minnesota Setting Facility Modifier None Typical Low $446,683.59 Median $478,630.09 Typical High $524,807.46 | Facility | None | $446,683.59 | $478,630.09 | $524,807.46 |
BCBS Minnesota Setting Professional Modifier None Typical Low $407,380.28 Median $457,088.19 Typical High $501,187.23 | Professional | None | $407,380.28 | $457,088.19 | $501,187.23 |
Cigna Setting Facility Modifier None Typical Low $602,559.59 Median $1,230,268.77 Typical High $1,659,586.91 | Facility | None | $602,559.59 | $1,230,268.77 | $1,659,586.91 |
Cigna Setting Professional Modifier None Typical Low $489,778.82 Median $537,031.80 Typical High $616,595.00 | Professional | None | $489,778.82 | $537,031.80 | $616,595.00 |
Health Partners Setting Facility Modifier None Typical Low $467,735.14 Median $1,148,153.62 Typical High $1,737,800.83 | Facility | None | $467,735.14 | $1,148,153.62 | $1,737,800.83 |
Health Partners Setting Professional Modifier None Typical Low $478,630.09 Median $478,630.09 Typical High $478,630.09 | Professional | None | $478,630.09 | $478,630.09 | $478,630.09 |
Medica Setting Facility Modifier None Typical Low $489,778.82 Median $758,577.58 Typical High $1,174,897.55 | Facility | None | $489,778.82 | $758,577.58 | $1,174,897.55 |
Medica Setting Professional Modifier None Typical Low $1,000,000.00 Median $1,000,000.00 Typical High $1,000,000.00 | Professional | None | $1,000,000.00 | $1,000,000.00 | $1,000,000.00 |
United Setting Facility Modifier None Typical Low $512,861.38 Median $512,861.38 Typical High $512,861.38 | Facility | None | $512,861.38 | $512,861.38 | $512,861.38 |
United Setting Professional Modifier None Typical Low $489,778.82 Median $489,778.82 Typical High $524,807.46 | Professional | None | $489,778.82 | $489,778.82 | $524,807.46 |
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 $257,039.58 Median $257,039.58 Typical High $257,039.58 | Facility | 52 · Reduced service | $257,039.58 | $257,039.58 | $257,039.58 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $102,329.30 Median $102,329.30 Typical High $102,329.30 | Facility | 53 · Discontinued | $102,329.30 | $102,329.30 | $102,329.30 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $75,857.76 Median $75,857.76 Typical High $75,857.76 | Facility | 55 · Aftercare only | $75,857.76 | $75,857.76 | $75,857.76 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $51,286.14 Median $51,286.14 Typical High $51,286.14 | Facility | 56 · Pre-op care only | $51,286.14 | $51,286.14 | $51,286.14 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $257,039.58 Median $257,039.58 Typical High $263,026.80 | Professional | 52 · Reduced service | $257,039.58 | $257,039.58 | $263,026.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102,329.30 Median $102,329.30 Typical High $104,712.85 | Professional | 53 · Discontinued | $102,329.30 | $102,329.30 | $104,712.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75,857.76 Median $75,857.76 Typical High $79,432.82 | Professional | 55 · Aftercare only | $75,857.76 | $75,857.76 | $79,432.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51,286.14 Median $51,286.14 Typical High $52,480.75 | Professional | 56 · Pre-op care only | $51,286.14 | $51,286.14 | $52,480.75 |
Where Minnesota sits
The same service costs 2.0 times more in Texas than in New Jersey. 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· 50th of 51
$501,187
TX $1,000,000NJ $489,779
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.