How much rates vary
Facilitymedian $105 · 10th to 90th $28 to $372Professionalmedian $48 · 10th to 90th $23 to $95
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 $16.60 Median $37.15 Typical High $316.23 | Facility | None | $16.60 | $37.15 | $316.23 |
Aetna Setting Professional Modifier None Typical Low $16.60 Median $31.62 Typical High $33.88 | Professional | None | $16.60 | $31.62 | $33.88 |
BCBS Minnesota Setting Facility Modifier None Typical Low $85.11 Median $213.80 Typical High $489.78 | Facility | None | $85.11 | $213.80 | $489.78 |
BCBS Minnesota Setting Professional Modifier None Typical Low $23.44 Median $46.77 Typical High $85.11 | Professional | None | $23.44 | $46.77 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $45.71 Median $72.44 Typical High $138.04 | Facility | None | $45.71 | $72.44 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $58.88 Typical High $114.82 | Professional | None | $30.90 | $58.88 | $114.82 |
Health Partners Setting Facility Modifier None Typical Low $40.74 Median $66.07 Typical High $114.82 | Facility | None | $40.74 | $66.07 | $114.82 |
Health Partners Setting Professional Modifier None Typical Low $25.70 Median $48.98 Typical High $100.00 | Professional | None | $25.70 | $48.98 | $100.00 |
Medica Setting Facility Modifier None Typical Low $27.54 Median $125.89 Typical High $831.76 | Facility | None | $27.54 | $125.89 | $831.76 |
Medica Setting Professional Modifier None Typical Low $37.15 Median $63.10 Typical High $131.83 | Professional | None | $37.15 | $63.10 | $131.83 |
United Setting Facility Modifier None Typical Low $125.89 Median $380.19 Typical High $1,778.28 | Facility | None | $125.89 | $380.19 | $1,778.28 |
United Setting Professional Modifier None Typical Low $21.38 Median $50.12 Typical High $107.15 | Professional | None | $21.38 | $50.12 | $107.15 |
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 $8.32 Median $15.85 Typical High $15.85 | Facility | 52 · Reduced service | $8.32 | $15.85 | $15.85 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $3.31 Median $6.31 Typical High $6.31 | Facility | 53 · Discontinued | $3.31 | $6.31 | $6.31 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $12.59 Median $23.99 Typical High $23.99 | Facility | 54 · Surgery only | $12.59 | $23.99 | $23.99 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $2.51 Median $4.79 Typical High $4.79 | Facility | 55 · Aftercare only | $2.51 | $4.79 | $4.79 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.66 Median $3.16 Typical High $3.16 | Facility | 56 · Pre-op care only | $1.66 | $3.16 | $3.16 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $8.32 Median $15.85 Typical High $15.85 | Professional | 52 · Reduced service | $8.32 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.31 Median $6.31 Typical High $6.31 | Professional | 53 · Discontinued | $3.31 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $12.59 Median $23.99 Typical High $23.99 | Professional | 54 · Surgery only | $12.59 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $4.79 Typical High $4.79 | Professional | 55 · Aftercare only | $2.51 | $4.79 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.66 Median $3.16 Typical High $3.16 | Professional | 56 · Pre-op care only | $1.66 | $3.16 | $3.16 |
Where Minnesota sits
The same service costs 3.5 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
$51.29
WI $87.10KY $25.12
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.