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 $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $190.55 Typical High $190.55 | Professional | None | $162.18 | $190.55 | $190.55 |
BCBS Minnesota Setting Facility Modifier None Typical Low $162.18 Median $245.47 Typical High $323.59 | Facility | None | $162.18 | $245.47 | $323.59 |
BCBS Minnesota Setting Professional Modifier None Typical Low $131.83 Median $147.91 Typical High $162.18 | Professional | None | $131.83 | $147.91 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $169.82 Typical High $204.17 | Facility | None | $162.18 | $169.82 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $177.83 Typical High $204.17 | Professional | None | $162.18 | $177.83 | $204.17 |
Health Partners Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $162.18 | Facility | None | $158.49 | $158.49 | $162.18 |
Health Partners Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
Medica Setting Facility Modifier None Typical Low $190.55 Median $257.04 Typical High $323.59 | Facility | None | $190.55 | $257.04 | $323.59 |
Medica Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $288.40 | Professional | None | $158.49 | $158.49 | $288.40 |
United Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $295.12 | Professional | None | $158.49 | $158.49 | $295.12 |
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 $95.50 Median $95.50 Typical High $95.50 | Facility | 52 · Reduced service | $95.50 | $95.50 | $95.50 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $38.02 | Facility | 53 · Discontinued | $38.02 | $38.02 | $38.02 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $28.84 | Facility | 55 · Aftercare only | $28.84 | $28.84 | $28.84 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $19.05 | Facility | 56 · Pre-op care only | $19.05 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $81.28 Median $95.50 Typical High $95.50 | Professional | 52 · Reduced service | $81.28 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $38.02 Typical High $38.02 | Professional | 53 · Discontinued | $32.36 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $24.55 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $19.05 Typical High $19.05 | Professional | 56 · Pre-op care only | $16.22 | $19.05 | $19.05 |
Where Minnesota sits
The same service costs 1.7 times more in Arizona than in Texas. 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· 13th of 51
$162
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.