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 $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
BCBS Minnesota Setting Facility Modifier None Typical Low $162.18 Median $588.84 Typical High $1,096.48 | Facility | None | $162.18 | $588.84 | $1,096.48 |
BCBS Minnesota Setting Professional Modifier None Typical Low $114.82 Median $141.25 Typical High $141.25 | Professional | None | $114.82 | $141.25 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $15.14 Median $23.44 Typical High $44.67 | Facility | None | $15.14 | $23.44 | $44.67 |
Cigna Setting Professional Modifier None Typical Low $10.23 Median $11.22 Typical High $12.88 | Professional | None | $10.23 | $11.22 | $12.88 |
Health Partners Setting Facility Modifier None Typical Low $13.49 Median $21.88 Typical High $38.02 | Facility | None | $13.49 | $21.88 | $38.02 |
Health Partners Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | None | $10.23 | $10.23 | $10.23 |
Medica Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Medica Setting Professional Modifier None Typical Low $41.69 Median $69.18 Typical High $141.25 | Professional | None | $41.69 | $69.18 | $141.25 |
United Setting Professional Modifier None Typical Low $41.69 Median $63.10 Typical High $141.25 | Professional | None | $41.69 | $63.10 | $141.25 |
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 $28.84 Median $28.84 Typical High $28.84 | Facility | 52 · Reduced service | $28.84 | $28.84 | $28.84 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $11.48 | Facility | 53 · Discontinued | $11.48 | $11.48 | $11.48 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.71 Median $8.71 Typical High $8.71 | Facility | 55 · Aftercare only | $8.71 | $8.71 | $8.71 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.75 Typical High $5.75 | Facility | 56 · Pre-op care only | $5.75 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | 52 · Reduced service | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | 53 · Discontinued | $11.48 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | 55 · Aftercare only | $8.71 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | 56 · Pre-op care only | $5.75 | $5.75 | $5.75 |
Where Minnesota sits
The same service costs 18.2 times more in North Carolina than in New York. 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· 35th of 51
$57.54
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.