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 $26.30 Typical High $26.30 | Facility | None | $23.44 | $26.30 | $26.30 |
Aetna Setting Professional Modifier None Typical Low $19.95 Median $23.44 Typical High $26.30 | Professional | None | $19.95 | $23.44 | $26.30 |
BCBS Minnesota Setting Facility Modifier None Typical Low $25.12 Median $54.95 Typical High $239.88 | Facility | None | $25.12 | $54.95 | $239.88 |
BCBS Minnesota Setting Professional Modifier None Typical Low $17.78 Median $25.70 Typical High $44.67 | Professional | None | $17.78 | $25.70 | $44.67 |
Cigna Setting Facility Modifier None Typical Low $39.81 Median $58.88 Typical High $169.82 | Facility | None | $39.81 | $58.88 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $17.38 Median $19.50 Typical High $24.55 | Professional | None | $17.38 | $19.50 | $24.55 |
Health Partners Setting Facility Modifier None Typical Low $36.31 Median $57.54 Typical High $134.90 | Facility | None | $36.31 | $57.54 | $134.90 |
Health Partners Setting Professional Modifier None Typical Low $17.38 Median $19.05 Typical High $19.05 | Professional | None | $17.38 | $19.05 | $19.05 |
Medica Setting Facility Modifier None Typical Low $12.59 Median $28.18 Typical High $39.81 | Facility | None | $12.59 | $28.18 | $39.81 |
Medica Setting Professional Modifier None Typical Low $17.38 Median $45.71 Typical High $107.15 | Professional | None | $17.38 | $45.71 | $107.15 |
United Setting Facility Modifier None Typical Low $12.30 Median $13.49 Typical High $13.49 | Facility | None | $12.30 | $13.49 | $13.49 |
United Setting Professional Modifier None Typical Low $14.79 Median $24.55 Typical High $51.29 | Professional | None | $14.79 | $24.55 | $51.29 |
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 $13.18 Typical High $13.18 | Facility | 52 · Reduced service | $11.75 | $13.18 | $13.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $4.79 Median $5.25 Typical High $5.25 | Facility | 53 · Discontinued | $4.79 | $5.25 | $5.25 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.55 Median $3.98 Typical High $3.98 | Facility | 55 · Aftercare only | $3.55 | $3.98 | $3.98 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.34 Median $2.63 Typical High $2.63 | Facility | 56 · Pre-op care only | $2.34 | $2.63 | $2.63 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.00 Median $11.75 Typical High $13.18 | Professional | 52 · Reduced service | $10.00 | $11.75 | $13.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $4.79 Typical High $5.25 | Professional | 53 · Discontinued | $4.07 | $4.79 | $5.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.55 Typical High $3.98 | Professional | 55 · Aftercare only | $3.02 | $3.55 | $3.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.00 Median $2.34 Typical High $2.63 | Professional | 56 · Pre-op care only | $2.00 | $2.34 | $2.63 |
Where Minnesota sits
The same service costs 3.2 times more in Alaska 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· 9th of 51
$22.91
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.