How much rates vary
Facilitymedian $355 · 10th to 90th $85 to $759Professionalmedian $282 · 10th to 90th $145 to $562
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 $85.11 Median $165.96 Typical High $537.03 | Facility | None | $85.11 | $165.96 | $537.03 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $144.54 Typical High $165.96 | Professional | None | $85.11 | $144.54 | $165.96 |
BCBS Minnesota Setting Facility Modifier None Typical Low $263.03 Median $426.58 Typical High $758.58 | Facility | None | $263.03 | $426.58 | $758.58 |
BCBS Minnesota Setting Professional Modifier None Typical Low $162.18 Median $331.13 Typical High $501.19 | Professional | None | $162.18 | $331.13 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $436.52 Typical High $831.76 | Facility | None | $281.84 | $436.52 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $295.12 Typical High $602.56 | Professional | None | $151.36 | $295.12 | $602.56 |
Health Partners Setting Facility Modifier None Typical Low $251.19 Median $398.11 Typical High $691.83 | Facility | None | $251.19 | $398.11 | $691.83 |
Health Partners Setting Professional Modifier None Typical Low $144.54 Median $288.40 Typical High $588.84 | Professional | None | $144.54 | $288.40 | $588.84 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $323.59 Typical High $1,230.27 | Facility | None | $125.89 | $323.59 | $1,230.27 |
Medica Setting Professional Modifier None Typical Low $208.93 Median $398.11 Typical High $1,479.11 | Professional | None | $208.93 | $398.11 | $1,479.11 |
United Setting Facility Modifier None Typical Low $125.89 Median $426.58 Typical High $1,778.28 | Facility | None | $125.89 | $426.58 | $1,778.28 |
United Setting Professional Modifier None Typical Low $123.03 Median $239.88 Typical High $512.86 | Professional | None | $123.03 | $239.88 | $512.86 |
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 $42.66 Median $83.18 Typical High $83.18 | Facility | 52 · Reduced service | $42.66 | $83.18 | $83.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $16.98 Median $33.88 Typical High $33.88 | Facility | 53 · Discontinued | $16.98 | $33.88 | $33.88 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $64.57 Median $125.89 Typical High $125.89 | Facility | 54 · Surgery only | $64.57 | $125.89 | $125.89 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.88 Median $25.12 Typical High $25.12 | Facility | 55 · Aftercare only | $12.88 | $25.12 | $25.12 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.51 Median $16.60 Typical High $16.60 | Facility | 56 · Pre-op care only | $8.51 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $42.66 Median $72.44 Typical High $83.18 | Professional | 52 · Reduced service | $42.66 | $72.44 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $28.84 Typical High $33.88 | Professional | 53 · Discontinued | $16.98 | $28.84 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $107.15 Typical High $125.89 | Professional | 54 · Surgery only | $64.57 | $107.15 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $21.88 Typical High $25.12 | Professional | 55 · Aftercare only | $12.88 | $21.88 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $14.45 Typical High $16.60 | Professional | 56 · Pre-op care only | $8.51 | $14.45 | $16.60 |
Where Minnesota sits
The same service costs 11.6 times more in Hawaii than in Maryland. 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
HI $3,027MD $261
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.