How much rates vary
Facilitymedian $224 · 10th to 90th $66 to $1,096Professionalmedian $191 · 10th to 90th $93 to $380
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 $66.07 Median $120.23 Typical High $120.23 | Facility | None | $66.07 | $120.23 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $112.20 Typical High $128.82 | Professional | None | $66.07 | $112.20 | $128.82 |
BCBS Setting Facility Modifier None Typical Low $134.90 Median $812.83 Typical High $1,905.46 | Facility | None | $134.90 | $812.83 | $1,905.46 |
BCBS Setting Professional Modifier None Typical Low $97.72 Median $190.55 Typical High $323.59 | Professional | None | $97.72 | $190.55 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $281.84 Typical High $549.54 | Facility | None | $181.97 | $281.84 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $251.19 Typical High $467.74 | Professional | None | $134.90 | $251.19 | $467.74 |
Health Partners Setting Facility Modifier None Typical Low $162.18 Median $263.03 Typical High $457.09 | Facility | None | $162.18 | $263.03 | $457.09 |
Health Partners Setting Professional Modifier None Typical Low $114.82 Median $218.78 Typical High $416.87 | Professional | None | $114.82 | $218.78 | $416.87 |
Medica Setting Facility Modifier None Typical Low $104.71 Median $229.09 Typical High $1,318.26 | Facility | None | $104.71 | $229.09 | $1,318.26 |
Medica Setting Professional Modifier None Typical Low $125.89 Median $295.12 Typical High $630.96 | Professional | None | $125.89 | $295.12 | $630.96 |
United Setting Facility Modifier None Typical Low $125.89 Median $426.58 Typical High $1,862.09 | Facility | None | $125.89 | $426.58 | $1,862.09 |
United Setting Professional Modifier None Typical Low $81.28 Median $181.97 Typical High $398.11 | Professional | None | $81.28 | $181.97 | $398.11 |
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 $33.11 Median $60.26 Typical High $60.26 | Facility | 52 · Reduced service | $33.11 | $60.26 | $60.26 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $13.18 Median $23.99 Typical High $23.99 | Facility | 53 · Discontinued | $13.18 | $23.99 | $23.99 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $48.98 Median $91.20 Typical High $91.20 | Facility | 54 · Surgery only | $48.98 | $91.20 | $91.20 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.77 Median $18.20 Typical High $18.20 | Facility | 55 · Aftercare only | $9.77 | $18.20 | $18.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.61 Median $12.02 Typical High $12.02 | Facility | 56 · Pre-op care only | $6.61 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $56.23 Typical High $60.26 | Professional | 52 · Reduced service | $33.11 | $56.23 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $22.39 Typical High $23.99 | Professional | 53 · Discontinued | $13.18 | $22.39 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $83.18 Typical High $91.20 | Professional | 54 · Surgery only | $48.98 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $16.60 Typical High $18.20 | Professional | 55 · Aftercare only | $9.77 | $16.60 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $11.22 Typical High $12.02 | Professional | 56 · Pre-op care only | $6.61 | $11.22 | $12.02 |
Where Minnesota sits
The same service costs 3.9 times more in Wisconsin than in Kentucky. 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· 3rd of 51
$195
WI $251KY $64.57
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.