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 $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $213.80 Typical High $213.80 | Professional | None | $181.97 | $213.80 | $213.80 |
BCBS Minnesota Setting Facility Modifier None Typical Low $2,041.74 Median $5,888.44 Typical High $12,589.25 | Facility | None | $2,041.74 | $5,888.44 | $12,589.25 |
BCBS Minnesota Setting Professional Modifier None Typical Low $645.65 Median $741.31 Typical High $831.76 | Professional | None | $645.65 | $741.31 | $831.76 |
Medica Setting Facility Modifier None Typical Low $263.03 Median $354.81 Typical High $4,073.80 | Facility | None | $263.03 | $354.81 | $4,073.80 |
Medica Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
10 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 $104.71 Median $104.71 Typical High $104.71 | Facility | 52 · Reduced service | $104.71 | $104.71 | $104.71 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $42.66 | Facility | 53 · Discontinued | $42.66 | $42.66 | $42.66 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | 54 · Surgery only | $158.49 | $158.49 | $158.49 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $31.62 | Facility | 55 · Aftercare only | $31.62 | $31.62 | $31.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.38 Typical High $21.38 | Facility | 56 · Pre-op care only | $21.38 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $104.71 Typical High $104.71 | Professional | 52 · Reduced service | $91.20 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $42.66 Typical High $42.66 | Professional | 53 · Discontinued | $36.31 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $158.49 Typical High $158.49 | Professional | 54 · Surgery only | $138.04 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $31.62 Typical High $31.62 | Professional | 55 · Aftercare only | $27.54 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $21.38 Typical High $21.38 | Professional | 56 · Pre-op care only | $18.20 | $21.38 | $21.38 |
Where Minnesota sits
The same service costs 25.7 times more in Oklahoma than in Vermont. 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· 3rd of 51
$661
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.