How much rates vary
Facilitymedian $447 · 10th to 90th $76 to $2,512Professionalmedian $229 · 10th to 90th $120 to $447
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 $75.86 Median $131.83 Typical High $1,819.70 | Facility | None | $75.86 | $131.83 | $1,819.70 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $123.03 Typical High $151.36 | Professional | None | $75.86 | $123.03 | $151.36 |
BCBS Minnesota Setting Facility Modifier None Typical Low $1,202.26 Median $2,818.38 Typical High $4,365.16 | Facility | None | $1,202.26 | $2,818.38 | $4,365.16 |
BCBS Minnesota Setting Professional Modifier None Typical Low $134.90 Median $245.47 Typical High $389.05 | Professional | None | $134.90 | $245.47 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $338.84 Typical High $645.65 | Facility | None | $218.78 | $338.84 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $257.04 Typical High $478.63 | Professional | None | $134.90 | $257.04 | $478.63 |
Health Partners Setting Facility Modifier None Typical Low $194.98 Median $316.23 Typical High $549.54 | Facility | None | $194.98 | $316.23 | $549.54 |
Health Partners Setting Professional Modifier None Typical Low $128.82 Median $234.42 Typical High $446.68 | Professional | None | $128.82 | $234.42 | $446.68 |
Medica Setting Facility Modifier None Typical Low $144.54 Median $676.08 Typical High $2,570.40 | Facility | None | $144.54 | $676.08 | $2,570.40 |
Medica Setting Professional Modifier None Typical Low $169.82 Median $346.74 Typical High $1,230.27 | Professional | None | $169.82 | $346.74 | $1,230.27 |
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 $104.71 Median $218.78 Typical High $478.63 | Professional | None | $104.71 | $218.78 | $478.63 |
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 $38.02 Median $66.07 Typical High $66.07 | Facility | 52 · Reduced service | $38.02 | $66.07 | $66.07 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $15.14 Median $26.30 Typical High $26.30 | Facility | 53 · Discontinued | $15.14 | $26.30 | $26.30 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $57.54 Median $100.00 Typical High $100.00 | Facility | 54 · Surgery only | $57.54 | $100.00 | $100.00 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $11.48 Median $19.95 Typical High $19.95 | Facility | 55 · Aftercare only | $11.48 | $19.95 | $19.95 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.59 Median $13.18 Typical High $13.18 | Facility | 56 · Pre-op care only | $7.59 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $61.66 Typical High $66.07 | Professional | 52 · Reduced service | $38.02 | $61.66 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $24.55 Typical High $26.30 | Professional | 53 · Discontinued | $15.14 | $24.55 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $91.20 Typical High $100.00 | Professional | 54 · Surgery only | $57.54 | $91.20 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $18.20 Typical High $19.95 | Professional | 55 · Aftercare only | $11.48 | $18.20 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $12.30 Typical High $13.18 | Professional | 56 · Pre-op care only | $7.59 | $12.30 | $13.18 |
Where Minnesota sits
The same service costs 8.0 times more in New York than in North Dakota. 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 $2,762ND $346
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.