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 $117.49 Median $467.74 Typical High $851.14 | Facility | None | $117.49 | $467.74 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $131.83 | Professional | None | $117.49 | $117.49 | $131.83 |
BCBS Minnesota Setting Facility Modifier None Typical Low $181.97 Median $354.81 Typical High $371.54 | Facility | None | $181.97 | $354.81 | $371.54 |
BCBS Minnesota Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $186.21 | Professional | None | $117.49 | $147.91 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $446.68 Typical High $602.56 | Facility | None | $218.78 | $446.68 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $131.83 Typical High $151.36 | Professional | None | $120.23 | $131.83 | $151.36 |
Health Partners Setting Facility Modifier None Typical Low $169.82 Median $416.87 Typical High $630.96 | Facility | None | $169.82 | $416.87 | $630.96 |
Health Partners Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Medica Setting Facility Modifier None Typical Low $93.33 Median $257.04 Typical High $645.65 | Facility | None | $93.33 | $257.04 | $645.65 |
Medica Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $354.81 | Professional | None | $194.98 | $194.98 | $354.81 |
United Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
United Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $275.42 | Professional | None | $147.91 | $147.91 | $275.42 |
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 $58.88 Median $58.88 Typical High $58.88 | Facility | 52 · Reduced service | $58.88 | $58.88 | $58.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $23.44 Median $23.44 Typical High $23.44 | Facility | 53 · Discontinued | $23.44 | $23.44 | $23.44 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $17.78 | Facility | 55 · Aftercare only | $17.78 | $17.78 | $17.78 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $11.75 | Facility | 56 · Pre-op care only | $11.75 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $58.88 Typical High $60.26 | Professional | 52 · Reduced service | $58.88 | $58.88 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $23.44 Typical High $23.99 | Professional | 53 · Discontinued | $23.44 | $23.44 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $18.20 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $12.02 | Professional | 56 · Pre-op care only | $11.75 | $11.75 | $12.02 |
Where Minnesota sits
The same service costs 2.0 times more in Kansas than in Georgia. 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· 20th of 51
$155
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.