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 $23.44 Median $23.44 Typical High $23.44 | Facility | None | $23.44 | $23.44 | $23.44 |
Aetna Setting Professional Modifier None Typical Low $21.38 Median $23.44 Typical High $26.30 | Professional | None | $21.38 | $23.44 | $26.30 |
BCBS Minnesota Setting Facility Modifier None Typical Low $104.71 Median $354.81 Typical High $776.25 | Facility | None | $104.71 | $354.81 | $776.25 |
BCBS Minnesota Setting Professional Modifier None Typical Low $37.15 Median $51.29 Typical High $66.07 | Professional | None | $37.15 | $51.29 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $75.86 Typical High $213.80 | Facility | None | $50.12 | $75.86 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $48.98 Typical High $79.43 | Professional | None | $33.11 | $48.98 | $79.43 |
Health Partners Setting Facility Modifier None Typical Low $44.67 Median $72.44 Typical High $169.82 | Facility | None | $44.67 | $72.44 | $169.82 |
Health Partners Setting Professional Modifier None Typical Low $32.36 Median $45.71 Typical High $74.13 | Professional | None | $32.36 | $45.71 | $74.13 |
Medica Setting Facility Modifier None Typical Low $29.51 Median $38.02 Typical High $524.81 | Facility | None | $29.51 | $38.02 | $524.81 |
Medica Setting Professional Modifier None Typical Low $32.36 Median $63.10 Typical High $165.96 | Professional | None | $32.36 | $63.10 | $165.96 |
United Setting Facility Modifier None Typical Low $549.54 Median $602.56 Typical High $776.25 | Facility | None | $549.54 | $602.56 | $776.25 |
United Setting Professional Modifier None Typical Low $28.18 Median $54.95 Typical High $100.00 | Professional | None | $28.18 | $54.95 | $100.00 |
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 $11.75 Median $11.75 Typical High $11.75 | Facility | 52 · Reduced service | $11.75 | $11.75 | $11.75 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $4.79 Median $4.79 Typical High $4.79 | Facility | 53 · Discontinued | $4.79 | $4.79 | $4.79 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.55 Median $3.55 Typical High $3.55 | Facility | 55 · Aftercare only | $3.55 | $3.55 | $3.55 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.34 Median $2.34 Typical High $2.34 | Facility | 56 · Pre-op care only | $2.34 | $2.34 | $2.34 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.72 Median $11.75 Typical High $13.18 | Professional | 52 · Reduced service | $10.72 | $11.75 | $13.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $4.79 Typical High $5.25 | Professional | 53 · Discontinued | $4.27 | $4.79 | $5.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $3.55 Typical High $3.72 | Professional | 55 · Aftercare only | $3.24 | $3.55 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $2.34 Typical High $2.63 | Professional | 56 · Pre-op care only | $2.14 | $2.34 | $2.63 |
Where Minnesota sits
The same service costs 2.5 times more in Iowa than in Pennsylvania. 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· 6th of 51
$47.86
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.