How much rates vary
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 $23.99 Median $58.88 Typical High $95.50 | Facility | None | $23.99 | $58.88 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $31.62 | Professional | None | $10.00 | $10.00 | $31.62 |
BCBS Setting Facility Modifier None Typical Low $89.13 Median $141.25 Typical High $275.42 | Facility | None | $89.13 | $141.25 | $275.42 |
BCBS Setting Professional Modifier None Typical Low $32.36 Median $42.66 Typical High $54.95 | Professional | None | $32.36 | $42.66 | $54.95 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $74.13 Typical High $208.93 | Facility | None | $48.98 | $74.13 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $54.95 Typical High $91.20 | Professional | None | $35.48 | $54.95 | $91.20 |
Health Partners Setting Facility Modifier None Typical Low $43.65 Median $69.18 Typical High $162.18 | Facility | None | $43.65 | $69.18 | $162.18 |
Health Partners Setting Professional Modifier None Typical Low $30.90 Median $48.98 Typical High $85.11 | Professional | None | $30.90 | $48.98 | $85.11 |
Medica Setting Facility Modifier None Typical Low $14.45 Median $41.69 Typical High $75.86 | Facility | None | $14.45 | $41.69 | $75.86 |
Medica Setting Professional Modifier None Typical Low $14.45 Median $36.31 Typical High $47.86 | Professional | None | $14.45 | $36.31 | $47.86 |
United Setting Facility Modifier None Typical Low $181.97 Median $194.98 Typical High $257.04 | Facility | None | $181.97 | $194.98 | $257.04 |
United Setting Professional Modifier None Typical Low $14.45 Median $35.48 Typical High $46.77 | Professional | None | $14.45 | $35.48 | $46.77 |
8 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 $5.01 Median $5.01 Typical High $5.01 | Facility | 52 · Reduced service | $5.01 | $5.01 | $5.01 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.00 Median $2.00 Typical High $2.00 | Facility | 53 · Discontinued | $2.00 | $2.00 | $2.00 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $1.51 Median $1.51 Typical High $1.51 | Facility | 55 · Aftercare only | $1.51 | $1.51 | $1.51 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.00 Median $1.00 Typical High $1.00 | Facility | 56 · Pre-op care only | $1.00 | $1.00 | $1.00 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | 52 · Reduced service | $5.01 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | 53 · Discontinued | $2.00 | $2.00 | $2.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $1.51 Typical High $1.51 | Professional | 55 · Aftercare only | $1.51 | $1.51 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | 56 · Pre-op care only | $1.00 | $1.00 | $1.00 |
Where Minnesota sits
The same service costs 5.4 times more in Vermont than in Kansas. 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· 5th of 51
$51.29
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.