How much rates vary
Facilitymedian $692 · 10th to 90th $166 to $1,698Professionalmedian $295 · 10th to 90th $155 to $562
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 $112.20 Median $1,174.90 Typical High $1,479.11 | Facility | None | $112.20 | $1,174.90 | $1,479.11 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $158.49 Typical High $173.78 | Professional | None | $112.20 | $158.49 | $173.78 |
BCBS Minnesota Setting Facility Modifier None Typical Low $616.60 Median $1,230.27 Typical High $2,630.27 | Facility | None | $616.60 | $1,230.27 | $2,630.27 |
BCBS Minnesota Setting Professional Modifier None Typical Low $186.21 Median $309.03 Typical High $501.19 | Professional | None | $186.21 | $309.03 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $446.68 Typical High $812.83 | Facility | None | $288.40 | $446.68 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $354.81 Typical High $588.84 | Professional | None | $186.21 | $354.81 | $588.84 |
Health Partners Setting Facility Modifier None Typical Low $245.47 Median $407.38 Typical High $691.83 | Facility | None | $245.47 | $407.38 | $691.83 |
Health Partners Setting Professional Modifier None Typical Low $186.21 Median $323.59 Typical High $562.34 | Professional | None | $186.21 | $323.59 | $562.34 |
Medica Setting Facility Modifier None Typical Low $223.87 Median $776.25 Typical High $2,570.40 | Facility | None | $223.87 | $776.25 | $2,570.40 |
Medica Setting Professional Modifier None Typical Low $194.98 Median $398.11 Typical High $1,258.93 | Professional | None | $194.98 | $398.11 | $1,258.93 |
United Setting Facility Modifier None Typical Low $549.54 Median $1,000.00 Typical High $3,162.28 | Facility | None | $549.54 | $1,000.00 | $3,162.28 |
United Setting Professional Modifier None Typical Low $134.90 Median $263.03 Typical High $549.54 | Professional | None | $134.90 | $263.03 | $549.54 |
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 $54.95 Median $83.18 Typical High $83.18 | Facility | 52 · Reduced service | $54.95 | $83.18 | $83.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $22.39 Median $33.88 Typical High $33.88 | Facility | 53 · Discontinued | $22.39 | $33.88 | $33.88 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $83.18 Median $125.89 Typical High $125.89 | Facility | 54 · Surgery only | $83.18 | $125.89 | $125.89 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.60 Median $25.12 Typical High $25.12 | Facility | 55 · Aftercare only | $16.60 | $25.12 | $25.12 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $11.22 Median $16.60 Typical High $16.60 | Facility | 56 · Pre-op care only | $11.22 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $77.62 Typical High $83.18 | Professional | 52 · Reduced service | $54.95 | $77.62 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $30.90 Typical High $33.88 | Professional | 53 · Discontinued | $22.39 | $30.90 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $117.49 Typical High $125.89 | Professional | 54 · Surgery only | $83.18 | $117.49 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $23.44 Typical High $25.12 | Professional | 55 · Aftercare only | $16.60 | $23.44 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $15.49 Typical High $16.60 | Professional | 56 · Pre-op care only | $11.22 | $15.49 | $16.60 |
Where Minnesota sits
The same service costs 6.3 times more in New York than in Montana. 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 $2,712MT $427
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.