How much rates vary
Facilitymedian $309 · 10th to 90th $91 to $933Professionalmedian $269 · 10th to 90th $141 to $537
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 $91.20 Median $141.25 Typical High $141.25 | Facility | None | $91.20 | $141.25 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $141.25 Typical High $177.83 | Professional | None | $91.20 | $141.25 | $177.83 |
BCBS Minnesota Setting Facility Modifier None Typical Low $239.88 Median $512.86 Typical High $1,148.15 | Facility | None | $239.88 | $512.86 | $1,148.15 |
BCBS Minnesota Setting Professional Modifier None Typical Low $162.18 Median $275.42 Typical High $478.63 | Professional | None | $162.18 | $275.42 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $389.05 Typical High $741.31 | Facility | None | $245.47 | $389.05 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $354.81 Typical High $645.65 | Professional | None | $213.80 | $354.81 | $645.65 |
Health Partners Setting Facility Modifier None Typical Low $218.78 Median $354.81 Typical High $616.60 | Facility | None | $218.78 | $354.81 | $616.60 |
Health Partners Setting Professional Modifier None Typical Low $186.21 Median $323.59 Typical High $602.56 | Professional | None | $186.21 | $323.59 | $602.56 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $309.03 Typical High $1,148.15 | Facility | None | $125.89 | $309.03 | $1,148.15 |
Medica Setting Professional Modifier None Typical Low $173.78 Median $380.19 Typical High $812.83 | Professional | None | $173.78 | $380.19 | $812.83 |
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 $131.83 Median $251.19 Typical High $524.81 | Professional | None | $131.83 | $251.19 | $524.81 |
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 $45.71 Median $70.79 Typical High $70.79 | Facility | 52 · Reduced service | $45.71 | $70.79 | $70.79 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $18.20 Median $28.18 Typical High $28.18 | Facility | 53 · Discontinued | $18.20 | $28.18 | $28.18 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $67.61 Median $104.71 Typical High $104.71 | Facility | 54 · Surgery only | $67.61 | $104.71 | $104.71 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.49 Median $21.38 Typical High $21.38 | Facility | 55 · Aftercare only | $13.49 | $21.38 | $21.38 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.12 Median $14.13 Typical High $14.13 | Facility | 56 · Pre-op care only | $9.12 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $67.61 Typical High $70.79 | Professional | 52 · Reduced service | $45.71 | $67.61 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $26.92 Typical High $28.18 | Professional | 53 · Discontinued | $18.20 | $26.92 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $100.00 Typical High $104.71 | Professional | 54 · Surgery only | $67.61 | $100.00 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $19.95 Typical High $21.38 | Professional | 55 · Aftercare only | $13.49 | $19.95 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $13.49 Typical High $14.13 | Professional | 56 · Pre-op care only | $9.12 | $13.49 | $14.13 |
Where Minnesota sits
The same service costs 3.2 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· 4th of 51
$282
WI $417KY $129
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.