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 $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $81.28 Typical High $81.28 | Professional | None | $64.57 | $81.28 | $81.28 |
BCBS Minnesota Setting Facility Modifier None Typical Low $79.43 Median $117.49 Typical High $158.49 | Facility | None | $79.43 | $117.49 | $158.49 |
BCBS Minnesota Setting Professional Modifier None Typical Low $63.10 Median $70.79 Typical High $79.43 | Professional | None | $63.10 | $70.79 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $194.98 Typical High $263.03 | Facility | None | $95.50 | $194.98 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $81.28 Typical High $93.33 | Professional | None | $74.13 | $81.28 | $93.33 |
Health Partners Setting Facility Modifier None Typical Low $75.86 Median $186.21 Typical High $275.42 | Facility | None | $75.86 | $186.21 | $275.42 |
Health Partners Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Medica Setting Facility Modifier None Typical Low $89.13 Median $104.71 Typical High $138.04 | Facility | None | $89.13 | $104.71 | $138.04 |
Medica Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $147.91 | Professional | None | $81.28 | $81.28 | $147.91 |
United Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $151.36 | Professional | None | $81.28 | $81.28 | $151.36 |
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 $40.74 Median $40.74 Typical High $40.74 | Facility | 52 · Reduced service | $40.74 | $40.74 | $40.74 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $16.22 | Facility | 53 · Discontinued | $16.22 | $16.22 | $16.22 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $12.02 | Facility | 55 · Aftercare only | $12.02 | $12.02 | $12.02 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $8.13 | Facility | 56 · Pre-op care only | $8.13 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $40.74 Typical High $40.74 | Professional | 52 · Reduced service | $32.36 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $16.22 Typical High $16.22 | Professional | 53 · Discontinued | $12.88 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $12.02 Typical High $12.02 | Professional | 55 · Aftercare only | $9.77 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $8.13 Typical High $8.13 | Professional | 56 · Pre-op care only | $6.46 | $8.13 | $8.13 |
Where Minnesota sits
The same service costs 1.9 times more in Alabama 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· 12th of 51
$81.28
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.