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 $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $27.54 | Professional | None | $24.55 | $24.55 | $27.54 |
BCBS Setting Facility Modifier None Typical Low $22.91 Median $34.67 Typical High $46.77 | Facility | None | $22.91 | $34.67 | $46.77 |
BCBS Setting Professional Modifier None Typical Low $19.50 Median $21.88 Typical High $23.99 | Professional | None | $19.50 | $21.88 | $23.99 |
Cigna Setting Facility Modifier None Typical Low $31.62 Median $64.57 Typical High $89.13 | Facility | None | $31.62 | $64.57 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $27.54 Typical High $31.62 | Professional | None | $25.12 | $27.54 | $31.62 |
Health Partners Setting Facility Modifier None Typical Low $25.12 Median $61.66 Typical High $93.33 | Facility | None | $25.12 | $61.66 | $93.33 |
Health Partners Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
Medica Setting Facility Modifier None Typical Low $23.44 Median $37.15 Typical High $44.67 | Facility | None | $23.44 | $37.15 | $44.67 |
Medica Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $42.66 | Professional | None | $23.44 | $23.44 | $42.66 |
United Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
United Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $44.67 | Professional | None | $23.99 | $23.99 | $44.67 |
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 $12.30 Median $12.30 Typical High $12.30 | Facility | 52 · Reduced service | $12.30 | $12.30 | $12.30 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $4.90 Median $4.90 Typical High $4.90 | Facility | 53 · Discontinued | $4.90 | $4.90 | $4.90 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $3.72 | Facility | 55 · Aftercare only | $3.72 | $3.72 | $3.72 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $2.45 | Facility | 56 · Pre-op care only | $2.45 | $2.45 | $2.45 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.30 Median $12.30 Typical High $12.59 | Professional | 52 · Reduced service | $12.30 | $12.30 | $12.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $4.90 Typical High $5.13 | Professional | 53 · Discontinued | $4.90 | $4.90 | $5.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $3.80 | Professional | 55 · Aftercare only | $3.72 | $3.72 | $3.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $2.51 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $2.51 |
Where Minnesota sits
The same service costs 234.4 times more in Alabama than in Maryland. 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· 38th of 51
$24.55
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.