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 $12.02 Median $12.02 Typical High $12.02 | Facility | None | $12.02 | $12.02 | $12.02 |
Aetna Setting Professional Modifier None Typical Low $10.23 Median $12.02 Typical High $12.02 | Professional | None | $10.23 | $12.02 | $12.02 |
BCBS Minnesota Setting Facility Modifier None Typical Low $6.03 Median $11.48 Typical High $18.20 | Facility | None | $6.03 | $11.48 | $18.20 |
BCBS Minnesota Setting Professional Modifier None Typical Low $10.00 Median $17.38 Typical High $21.88 | Professional | None | $10.00 | $17.38 | $21.88 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $75.86 Typical High $102.33 | Facility | None | $37.15 | $75.86 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $31.62 Typical High $36.31 | Professional | None | $28.84 | $31.62 | $36.31 |
Health Partners Setting Facility Modifier None Typical Low $28.84 Median $70.79 Typical High $107.15 | Facility | None | $28.84 | $70.79 | $107.15 |
Health Partners Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
Medica Setting Facility Modifier None Typical Low $16.22 Median $26.30 Typical High $30.20 | Facility | None | $16.22 | $26.30 | $30.20 |
Medica Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $19.05 | Professional | None | $10.72 | $10.72 | $19.05 |
United Setting Facility Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Facility | None | $3.89 | $3.89 | $3.89 |
United Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $18.62 | Professional | None | $10.00 | $10.00 | $18.62 |
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 $6.03 Median $6.03 Typical High $6.03 | Facility | 52 · Reduced service | $6.03 | $6.03 | $6.03 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.40 Median $2.40 Typical High $2.40 | Facility | 53 · Discontinued | $2.40 | $2.40 | $2.40 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $1.82 Median $1.82 Typical High $1.82 | Facility | 55 · Aftercare only | $1.82 | $1.82 | $1.82 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.20 Median $1.20 Typical High $1.20 | Facility | 56 · Pre-op care only | $1.20 | $1.20 | $1.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $5.13 Median $6.03 Typical High $6.03 | Professional | 52 · Reduced service | $5.13 | $6.03 | $6.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.04 Median $2.40 Typical High $2.40 | Professional | 53 · Discontinued | $2.04 | $2.40 | $2.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $1.82 Typical High $1.82 | Professional | 55 · Aftercare only | $1.51 | $1.82 | $1.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.02 Median $1.20 Typical High $1.20 | Professional | 56 · Pre-op care only | $1.02 | $1.20 | $1.20 |
Where Minnesota sits
The same service costs 9.1 times more in Alabama than in Virginia. 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
$17.38
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.