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 Setting Facility Modifier None Typical Low $48.98 Median $239.88 Typical High $316.23 | Facility | None | $48.98 | $239.88 | $316.23 |
BCBS Setting Professional Modifier None Typical Low $125.89 Median $141.25 Typical High $158.49 | Professional | None | $125.89 | $141.25 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $141.25 Typical High $194.98 | Facility | None | $69.18 | $141.25 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $61.66 Typical High $67.61 | Professional | None | $53.70 | $61.66 | $67.61 |
Health Partners Setting Facility Modifier None Typical Low $54.95 Median $134.90 Typical High $199.53 | Facility | None | $54.95 | $134.90 | $199.53 |
Health Partners Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
Medica Setting Facility Modifier None Typical Low $48.98 Median $67.61 Typical High $316.23 | Facility | None | $48.98 | $67.61 | $316.23 |
Medica Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $281.84 | Professional | None | $154.88 | $154.88 | $281.84 |
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 4.4 times more in Alaska than in Hawaii. 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· 43rd 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.