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 $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $257.04 | Professional | None | $194.98 | $194.98 | $257.04 |
BCBS Minnesota Setting Facility Modifier None Typical Low $186.21 Median $371.54 Typical High $407.38 | Facility | None | $186.21 | $371.54 | $407.38 |
BCBS Minnesota Setting Professional Modifier None Typical Low $154.88 Median $177.83 Typical High $194.98 | Professional | None | $154.88 | $177.83 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $457.09 Typical High $630.96 | Facility | None | $223.87 | $457.09 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $199.53 Typical High $223.87 | Professional | None | $177.83 | $199.53 | $223.87 |
Health Partners Setting Facility Modifier None Typical Low $177.83 Median $436.52 Typical High $660.69 | Facility | None | $177.83 | $436.52 | $660.69 |
Health Partners Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
Medica Setting Facility Modifier None Typical Low $95.50 Median $204.17 Typical High $316.23 | Facility | None | $95.50 | $204.17 | $316.23 |
Medica Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $239.88 | Professional | None | $199.53 | $199.53 | $239.88 |
United Setting Professional Modifier None Typical Low $199.53 Median $208.93 Typical High $269.15 | Professional | None | $199.53 | $208.93 | $269.15 |
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 $97.72 Median $97.72 Typical High $97.72 | Facility | 52 · Reduced service | $97.72 | $97.72 | $97.72 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | 53 · Discontinued | $38.90 | $38.90 | $38.90 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $29.51 | Facility | 55 · Aftercare only | $29.51 | $29.51 | $29.51 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $19.50 | Facility | 56 · Pre-op care only | $19.50 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 52 · Reduced service | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | 53 · Discontinued | $38.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | 55 · Aftercare only | $29.51 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | 56 · Pre-op care only | $19.50 | $19.50 | $19.50 |
Where Minnesota sits
The same service costs 549.5 times more in Arizona than in Rhode Island. 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· 43rd of 51
$195
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.