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 $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $75.86 | Professional | None | $63.10 | $63.10 | $75.86 |
BCBS Minnesota Setting Facility Modifier None Typical Low $97.72 Median $109.65 Typical High $169.82 | Facility | None | $97.72 | $109.65 | $169.82 |
BCBS Minnesota Setting Professional Modifier None Typical Low $87.10 Median $109.65 Typical High $109.65 | Professional | None | $87.10 | $109.65 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $316.23 Typical High $812.83 | Facility | None | $64.57 | $316.23 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $109.65 Typical High $138.04 | Professional | None | $107.15 | $109.65 | $138.04 |
Health Partners Setting Facility Modifier None Typical Low $204.17 Median $323.59 Typical High $758.58 | Facility | None | $204.17 | $323.59 | $758.58 |
Health Partners Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
Medica Setting Facility Modifier None Typical Low $61.66 Median $93.33 Typical High $426.58 | Facility | None | $61.66 | $93.33 | $426.58 |
Medica Setting Professional Modifier None Typical Low $38.02 Median $54.95 Typical High $478.63 | Professional | None | $38.02 | $54.95 | $478.63 |
United Setting Professional Modifier None Typical Low $30.20 Median $46.77 Typical High $93.33 | Professional | None | $30.20 | $46.77 | $93.33 |
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 $31.62 Median $31.62 Typical High $31.62 | Facility | 52 · Reduced service | $31.62 | $31.62 | $31.62 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.59 Median $12.59 Typical High $12.59 | Facility | 53 · Discontinued | $12.59 | $12.59 | $12.59 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.55 Median $9.55 Typical High $9.55 | Facility | 55 · Aftercare only | $9.55 | $9.55 | $9.55 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.31 Typical High $6.31 | Facility | 56 · Pre-op care only | $6.31 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $31.62 Median $31.62 Typical High $38.02 | Professional | 52 · Reduced service | $31.62 | $31.62 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $12.59 Typical High $15.14 | Professional | 53 · Discontinued | $12.59 | $12.59 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $9.55 Typical High $11.22 | Professional | 55 · Aftercare only | $9.55 | $9.55 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.31 Typical High $7.59 | Professional | 56 · Pre-op care only | $6.31 | $6.31 | $7.59 |
Where Minnesota sits
The same service costs 2.5 times more in Hawaii than in Rhode Island. 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· 5th of 51
$107
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.