How much rates vary
Facilitymedian $1,514 · 10th to 90th $282 to $4,365Professionalmedian $447 · 10th to 90th $204 to $891
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 $141.25 Median $1,659.59 Typical High $5,495.41 | Facility | None | $141.25 | $1,659.59 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $275.42 Typical High $331.13 | Professional | None | $141.25 | $275.42 | $331.13 |
BCBS Minnesota Setting Facility Modifier None Typical Low $776.25 Median $2,818.38 Typical High $6,456.54 | Facility | None | $776.25 | $2,818.38 | $6,456.54 |
BCBS Minnesota Setting Professional Modifier None Typical Low $218.78 Median $467.74 Typical High $758.58 | Professional | None | $218.78 | $467.74 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $660.69 Typical High $1,258.93 | Facility | None | $426.58 | $660.69 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $549.54 Typical High $1,096.48 | Professional | None | $288.40 | $549.54 | $1,096.48 |
Health Partners Setting Facility Modifier None Typical Low $380.19 Median $616.60 Typical High $1,071.52 | Facility | None | $380.19 | $616.60 | $1,071.52 |
Health Partners Setting Professional Modifier None Typical Low $257.04 Median $501.19 Typical High $954.99 | Professional | None | $257.04 | $501.19 | $954.99 |
Medica Setting Facility Modifier None Typical Low $295.12 Median $1,258.93 Typical High $3,981.07 | Facility | None | $295.12 | $1,258.93 | $3,981.07 |
Medica Setting Professional Modifier None Typical Low $331.13 Median $660.69 Typical High $1,445.44 | Professional | None | $331.13 | $660.69 | $1,445.44 |
United Setting Facility Modifier None Typical Low $776.25 Median $1,659.59 Typical High $4,466.84 | Facility | None | $776.25 | $1,659.59 | $4,466.84 |
United Setting Professional Modifier None Typical Low $190.55 Median $426.58 Typical High $891.25 | Professional | None | $190.55 | $426.58 | $891.25 |
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 $70.79 Median $141.25 Typical High $141.25 | Facility | 52 · Reduced service | $70.79 | $141.25 | $141.25 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $28.18 Median $56.23 Typical High $56.23 | Facility | 53 · Discontinued | $28.18 | $56.23 | $56.23 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $107.15 Median $213.80 Typical High $213.80 | Facility | 54 · Surgery only | $107.15 | $213.80 | $213.80 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $21.38 Median $42.66 Typical High $42.66 | Facility | 55 · Aftercare only | $21.38 | $42.66 | $42.66 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $14.13 Median $28.18 Typical High $28.18 | Facility | 56 · Pre-op care only | $14.13 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $125.89 Typical High $141.25 | Professional | 52 · Reduced service | $70.79 | $125.89 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $51.29 Typical High $56.23 | Professional | 53 · Discontinued | $28.18 | $51.29 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $190.55 Typical High $213.80 | Professional | 54 · Surgery only | $107.15 | $190.55 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $38.02 Typical High $42.66 | Professional | 55 · Aftercare only | $21.38 | $38.02 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $25.70 Typical High $28.18 | Professional | 56 · Pre-op care only | $14.13 | $25.70 | $28.18 |
Where Minnesota sits
The same service costs 8.2 times more in Colorado than in West Virginia. 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
CO $4,192WV $514
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.