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 $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $229.09 | Professional | None | $208.93 | $208.93 | $229.09 |
BCBS Setting Facility Modifier None Typical Low $208.93 Median $407.38 Typical High $436.52 | Facility | None | $208.93 | $407.38 | $436.52 |
BCBS Setting Professional Modifier None Typical Low $151.36 Median $169.82 Typical High $199.53 | Professional | None | $151.36 | $169.82 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $263.03 Typical High $309.03 | Facility | None | $245.47 | $263.03 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $234.42 Typical High $269.15 | Professional | None | $213.80 | $234.42 | $269.15 |
Health Partners Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Health Partners Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
Medica Setting Facility Modifier None Typical Low $120.23 Median $213.80 Typical High $467.74 | Facility | None | $120.23 | $213.80 | $467.74 |
Medica Setting Professional Modifier None Typical Low $213.80 Median $234.42 Typical High $389.05 | Professional | None | $213.80 | $234.42 | $389.05 |
United Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
United Setting Professional Modifier None Typical Low $186.21 Median $208.93 Typical High $354.81 | Professional | None | $186.21 | $208.93 | $354.81 |
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 $104.71 Median $104.71 Typical High $104.71 | Facility | 52 · Reduced service | $104.71 | $104.71 | $104.71 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $41.69 | Facility | 53 · Discontinued | $41.69 | $41.69 | $41.69 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $30.90 | Facility | 55 · Aftercare only | $30.90 | $30.90 | $30.90 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $20.89 | Facility | 56 · Pre-op care only | $20.89 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $104.71 Median $104.71 Typical High $107.15 | Professional | 52 · Reduced service | $104.71 | $104.71 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $42.66 | Professional | 53 · Discontinued | $41.69 | $41.69 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $32.36 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $21.38 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $21.38 |
Where Minnesota sits
The same service costs 28.2 times more in Alabama than in Rhode Island. 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· 21st of 51
$214
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.