How much rates vary
Facilitymedian $417 · 10th to 90th $138 to $1,047Professionalmedian $398 · 10th to 90th $204 to $759
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 $138.04 Median $239.88 Typical High $239.88 | Facility | None | $138.04 | $239.88 | $239.88 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $213.80 Typical High $239.88 | Professional | None | $138.04 | $213.80 | $239.88 |
BCBS Minnesota Setting Facility Modifier None Typical Low $354.81 Median $776.25 Typical High $1,862.09 | Facility | None | $354.81 | $776.25 | $1,862.09 |
BCBS Minnesota Setting Professional Modifier None Typical Low $234.42 Median $436.52 Typical High $691.83 | Professional | None | $234.42 | $436.52 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $602.56 Typical High $1,148.15 | Facility | None | $389.05 | $602.56 | $1,148.15 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $457.09 Typical High $851.14 | Professional | None | $229.09 | $457.09 | $851.14 |
Health Partners Setting Facility Modifier None Typical Low $346.74 Median $562.34 Typical High $977.24 | Facility | None | $346.74 | $562.34 | $977.24 |
Health Partners Setting Professional Modifier None Typical Low $229.09 Median $416.87 Typical High $794.33 | Professional | None | $229.09 | $416.87 | $794.33 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $331.13 Typical High $1,148.15 | Facility | None | $125.89 | $331.13 | $1,148.15 |
Medica Setting Professional Modifier None Typical Low $239.88 Median $501.19 Typical High $1,698.24 | Professional | None | $239.88 | $501.19 | $1,698.24 |
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 $154.88 Median $331.13 Typical High $691.83 | Professional | None | $154.88 | $331.13 | $691.83 |
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 $69.18 Median $120.23 Typical High $120.23 | Facility | 52 · Reduced service | $69.18 | $120.23 | $120.23 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $27.54 Median $47.86 Typical High $47.86 | Facility | 53 · Discontinued | $27.54 | $47.86 | $47.86 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $20.42 Median $35.48 Typical High $35.48 | Facility | 55 · Aftercare only | $20.42 | $35.48 | $35.48 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $13.80 Median $23.99 Typical High $23.99 | Facility | 56 · Pre-op care only | $13.80 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $69.18 Median $109.65 Typical High $120.23 | Professional | 52 · Reduced service | $69.18 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $43.65 Typical High $47.86 | Professional | 53 · Discontinued | $27.54 | $43.65 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $32.36 Typical High $35.48 | Professional | 55 · Aftercare only | $20.42 | $32.36 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $21.88 Typical High $23.99 | Professional | 56 · Pre-op care only | $13.80 | $21.88 | $23.99 |
Where Minnesota sits
The same service costs 8.0 times more in New York 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
NY $2,495MD $313
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.