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 $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $295.12 Typical High $295.12 | Professional | None | $288.40 | $295.12 | $295.12 |
BCBS Minnesota Setting Facility Modifier None Typical Low $831.76 Median $870.96 Typical High $5,248.07 | Facility | None | $831.76 | $870.96 | $5,248.07 |
BCBS Minnesota Setting Professional Modifier None Typical Low $707.95 Median $794.33 Typical High $870.96 | Professional | None | $707.95 | $794.33 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
Medica Setting Facility Modifier None Typical Low $549.54 Median $1,288.25 Typical High $3,388.44 | Facility | None | $549.54 | $1,288.25 | $3,388.44 |
Medica Setting Professional Modifier None Typical Low $389.05 Median $724.44 Typical High $2,344.23 | Professional | None | $389.05 | $724.44 | $2,344.23 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,513.56 Typical High $3,630.78 | Facility | None | $758.58 | $1,513.56 | $3,630.78 |
United Setting Professional Modifier None Typical Low $380.19 Median $676.08 Typical High $1,412.54 | Professional | None | $380.19 | $676.08 | $1,412.54 |
10 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 $147.91 Median $147.91 Typical High $147.91 | Facility | 52 · Reduced service | $147.91 | $147.91 | $147.91 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $58.88 Median $58.88 Typical High $58.88 | Facility | 53 · Discontinued | $58.88 | $58.88 | $58.88 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | 54 · Surgery only | $218.78 | $218.78 | $218.78 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $44.67 | Facility | 55 · Aftercare only | $44.67 | $44.67 | $44.67 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $29.51 | Facility | 56 · Pre-op care only | $29.51 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $144.54 Median $147.91 Typical High $147.91 | Professional | 52 · Reduced service | $144.54 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $58.88 Typical High $58.88 | Professional | 53 · Discontinued | $57.54 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $218.78 Typical High $218.78 | Professional | 54 · Surgery only | $213.80 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $44.67 Typical High $44.67 | Professional | 55 · Aftercare only | $42.66 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $29.51 Typical High $29.51 | Professional | 56 · Pre-op care only | $28.84 | $29.51 | $29.51 |
Where Minnesota sits
The same service costs 6.3 times more in Texas than in Pennsylvania. 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· 5th of 51
$794
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.