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 $10.00 Median $10.00 Typical High $33.11 | Facility | None | $10.00 | $10.00 | $33.11 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $38.02 | Professional | None | $10.00 | $10.00 | $38.02 |
BCBS Minnesota Setting Facility Modifier None Typical Low $56.23 Median $109.65 Typical High $213.80 | Facility | None | $56.23 | $109.65 | $213.80 |
BCBS Minnesota Setting Professional Modifier None Typical Low $13.49 Median $26.30 Typical High $33.11 | Professional | None | $13.49 | $26.30 | $33.11 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $120.23 Typical High $346.74 | Facility | None | $79.43 | $120.23 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $93.33 Typical High $154.88 | Professional | None | $61.66 | $93.33 | $154.88 |
Health Partners Setting Facility Modifier None Typical Low $72.44 Median $114.82 Typical High $269.15 | Facility | None | $72.44 | $114.82 | $269.15 |
Health Partners Setting Professional Modifier None Typical Low $57.54 Median $81.28 Typical High $138.04 | Professional | None | $57.54 | $81.28 | $138.04 |
Medica Setting Facility Modifier None Typical Low $13.49 Median $37.15 Typical High $74.13 | Facility | None | $13.49 | $37.15 | $74.13 |
Medica Setting Professional Modifier None Typical Low $14.45 Median $36.31 Typical High $47.86 | Professional | None | $14.45 | $36.31 | $47.86 |
United Setting Facility Modifier None Typical Low $117.49 Median $128.82 Typical High $165.96 | Facility | None | $117.49 | $128.82 | $165.96 |
United Setting Professional Modifier None Typical Low $14.45 Median $35.48 Typical High $47.86 | Professional | None | $14.45 | $35.48 | $47.86 |
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 $5.01 Median $5.01 Typical High $5.01 | Facility | 52 · Reduced service | $5.01 | $5.01 | $5.01 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.00 Median $2.00 Typical High $2.00 | Facility | 53 · Discontinued | $2.00 | $2.00 | $2.00 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $1.51 Median $1.51 Typical High $1.51 | Facility | 55 · Aftercare only | $1.51 | $1.51 | $1.51 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.00 Median $1.00 Typical High $1.00 | Facility | 56 · Pre-op care only | $1.00 | $1.00 | $1.00 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | 52 · Reduced service | $5.01 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | 53 · Discontinued | $2.00 | $2.00 | $2.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $1.51 Typical High $1.51 | Professional | 55 · Aftercare only | $1.51 | $1.51 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | 56 · Pre-op care only | $1.00 | $1.00 | $1.00 |
Where Minnesota sits
The same service costs 6.6 times more in Alabama than in Kansas. 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· 16th of 51
$33.11
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.