How much rates vary
Facilitymedian $407 · 10th to 90th $120 to $912Professionalmedian $417 · 10th to 90th $209 to $776
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 $120.23 Median $208.93 Typical High $407.38 | Facility | None | $120.23 | $208.93 | $407.38 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $208.93 Typical High $245.47 | Professional | None | $120.23 | $208.93 | $245.47 |
BCBS Minnesota Setting Facility Modifier None Typical Low $302.00 Median $575.44 Typical High $954.99 | Facility | None | $302.00 | $575.44 | $954.99 |
BCBS Minnesota Setting Professional Modifier None Typical Low $234.42 Median $426.58 Typical High $691.83 | Professional | None | $234.42 | $426.58 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $575.44 Typical High $1,096.48 | Facility | None | $363.08 | $575.44 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $501.19 Typical High $933.25 | Professional | None | $288.40 | $501.19 | $933.25 |
Health Partners Setting Facility Modifier None Typical Low $323.59 Median $524.81 Typical High $912.01 | Facility | None | $323.59 | $524.81 | $912.01 |
Health Partners Setting Professional Modifier None Typical Low $245.47 Median $457.09 Typical High $891.25 | Professional | None | $245.47 | $457.09 | $891.25 |
Medica Setting Facility Modifier None Typical Low $131.83 Median $346.74 Typical High $1,445.44 | Facility | None | $131.83 | $346.74 | $1,445.44 |
Medica Setting Professional Modifier None Typical Low $263.03 Median $549.54 Typical High $1,122.02 | Professional | None | $263.03 | $549.54 | $1,122.02 |
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 $177.83 Median $371.54 Typical High $758.58 | Professional | None | $177.83 | $371.54 | $758.58 |
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 $60.26 Median $104.71 Typical High $104.71 | Facility | 52 · Reduced service | $60.26 | $104.71 | $104.71 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $23.99 Median $41.69 Typical High $41.69 | Facility | 53 · Discontinued | $23.99 | $41.69 | $41.69 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $91.20 Median $154.88 Typical High $154.88 | Facility | 54 · Surgery only | $91.20 | $154.88 | $154.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $18.20 Median $31.62 Typical High $31.62 | Facility | 55 · Aftercare only | $18.20 | $31.62 | $31.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.02 Median $20.89 Typical High $20.89 | Facility | 56 · Pre-op care only | $12.02 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $104.71 Typical High $107.15 | Professional | 52 · Reduced service | $60.26 | $104.71 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $41.69 Typical High $42.66 | Professional | 53 · Discontinued | $23.99 | $41.69 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $154.88 Typical High $158.49 | Professional | 54 · Surgery only | $91.20 | $154.88 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $31.62 Typical High $31.62 | Professional | 55 · Aftercare only | $18.20 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $20.89 Typical High $21.38 | Professional | 56 · Pre-op care only | $12.02 | $20.89 | $21.38 |
Where Minnesota sits
The same service costs 8.8 times more in New York than in Alabama. 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 $2,761AL $314
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.