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 $15.85 Median $15.85 Typical High $15.85 | Facility | None | $15.85 | $15.85 | $15.85 |
Aetna Setting Professional Modifier None Typical Low $13.18 Median $15.85 Typical High $15.85 | Professional | None | $13.18 | $15.85 | $15.85 |
BCBS Minnesota Setting Facility Modifier None Typical Low $52.48 Median $109.65 Typical High $263.03 | Facility | None | $52.48 | $109.65 | $263.03 |
BCBS Minnesota Setting Professional Modifier None Typical Low $22.91 Median $27.54 Typical High $38.90 | Professional | None | $22.91 | $27.54 | $38.90 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $50.12 Typical High $141.25 | Facility | None | $33.11 | $50.12 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $10.00 Median $12.59 Typical High $39.81 | Professional | None | $10.00 | $12.59 | $39.81 |
Health Partners Setting Facility Modifier None Typical Low $29.51 Median $46.77 Typical High $112.20 | Facility | None | $29.51 | $46.77 | $112.20 |
Health Partners Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $38.02 | Professional | None | $10.00 | $10.00 | $38.02 |
Medica Setting Facility Modifier None Typical Low $19.95 Median $30.90 Typical High $489.78 | Facility | None | $19.95 | $30.90 | $489.78 |
Medica Setting Professional Modifier None Typical Low $11.22 Median $14.13 Typical High $1,905.46 | Professional | None | $11.22 | $14.13 | $1,905.46 |
United Setting Facility Modifier None Typical Low $93.33 Median $102.33 Typical High $134.90 | Facility | None | $93.33 | $102.33 | $134.90 |
United Setting Professional Modifier None Typical Low $11.22 Median $13.49 Typical High $32.36 | Professional | None | $11.22 | $13.49 | $32.36 |
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 $7.94 Median $7.94 Typical High $7.94 | Facility | 52 · Reduced service | $7.94 | $7.94 | $7.94 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $3.16 Median $3.16 Typical High $3.16 | Facility | 53 · Discontinued | $3.16 | $3.16 | $3.16 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $2.40 Median $2.40 Typical High $2.40 | Facility | 55 · Aftercare only | $2.40 | $2.40 | $2.40 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.58 Median $1.58 Typical High $1.58 | Facility | 56 · Pre-op care only | $1.58 | $1.58 | $1.58 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $6.61 Median $7.94 Typical High $7.94 | Professional | 52 · Reduced service | $6.61 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.63 Median $3.16 Typical High $3.16 | Professional | 53 · Discontinued | $2.63 | $3.16 | $3.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.00 Median $2.40 Typical High $2.40 | Professional | 55 · Aftercare only | $2.00 | $2.40 | $2.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.32 Median $1.58 Typical High $1.58 | Professional | 56 · Pre-op care only | $1.32 | $1.58 | $1.58 |
Where Minnesota sits
The same service costs 43.7 times more in Hawaii than in Florida. 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· 27th of 51
$15.85
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.