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 $95.50 Median $309.03 Typical High $457.09 | Facility | None | $95.50 | $309.03 | $457.09 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $95.50 Typical High $104.71 | Professional | None | $89.13 | $95.50 | $104.71 |
BCBS Minnesota Setting Facility Modifier None Typical Low $147.91 Median $302.00 Typical High $794.33 | Facility | None | $147.91 | $302.00 | $794.33 |
BCBS Minnesota Setting Professional Modifier None Typical Low $112.20 Median $151.36 Typical High $251.19 | Professional | None | $112.20 | $151.36 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $302.00 Typical High $870.96 | Facility | None | $199.53 | $302.00 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $186.21 Typical High $295.12 | Professional | None | $134.90 | $186.21 | $295.12 |
Health Partners Setting Facility Modifier None Typical Low $181.97 Median $288.40 Typical High $676.08 | Facility | None | $181.97 | $288.40 | $676.08 |
Health Partners Setting Professional Modifier None Typical Low $128.82 Median $154.88 Typical High $269.15 | Professional | None | $128.82 | $154.88 | $269.15 |
Medica Setting Facility Modifier None Typical Low $104.71 Median $218.78 Typical High $363.08 | Facility | None | $104.71 | $218.78 | $363.08 |
Medica Setting Professional Modifier None Typical Low $89.13 Median $158.49 Typical High $537.03 | Professional | None | $89.13 | $158.49 | $537.03 |
United Setting Facility Modifier None Typical Low $85.11 Median $93.33 Typical High $93.33 | Facility | None | $85.11 | $93.33 | $93.33 |
United Setting Professional Modifier None Typical Low $75.86 Median $138.04 Typical High $281.84 | Professional | None | $75.86 | $138.04 | $281.84 |
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 $47.86 Median $47.86 Typical High $47.86 | Facility | 52 · Reduced service | $47.86 | $47.86 | $47.86 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $19.50 Median $19.50 Typical High $19.50 | Facility | 53 · Discontinued | $19.50 | $19.50 | $19.50 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $14.45 Median $14.45 Typical High $14.45 | Facility | 55 · Aftercare only | $14.45 | $14.45 | $14.45 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.55 Median $9.55 Typical High $9.55 | Facility | 56 · Pre-op care only | $9.55 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $44.67 Median $47.86 Typical High $47.86 | Professional | 52 · Reduced service | $44.67 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $19.50 Typical High $19.50 | Professional | 53 · Discontinued | $18.20 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $14.45 Typical High $14.45 | Professional | 55 · Aftercare only | $13.49 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.55 Typical High $9.55 | Professional | 56 · Pre-op care only | $9.12 | $9.55 | $9.55 |
Where Minnesota sits
The same service costs 2.9 times more in Alaska than in Utah. 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· 4th of 51
$158
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.