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 $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $302.00 Typical High $302.00 | Professional | None | $257.04 | $302.00 | $302.00 |
BCBS Minnesota Setting Facility Modifier None Typical Low $234.42 Median $380.19 Typical High $512.86 | Facility | None | $234.42 | $380.19 | $512.86 |
BCBS Minnesota Setting Professional Modifier None Typical Low $204.17 Median $257.04 Typical High $257.04 | Professional | None | $204.17 | $257.04 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $588.84 Typical High $812.83 | Facility | None | $275.42 | $588.84 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $239.88 Typical High $281.84 | Professional | None | $223.87 | $239.88 | $281.84 |
Health Partners Setting Facility Modifier None Typical Low $229.09 Median $562.34 Typical High $831.76 | Facility | None | $229.09 | $562.34 | $831.76 |
Health Partners Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
Medica Setting Facility Modifier None Typical Low $72.44 Median $223.87 Typical High $407.38 | Facility | None | $72.44 | $223.87 | $407.38 |
Medica Setting Professional Modifier None Typical Low $100.00 Median $251.19 Typical High $338.84 | Professional | None | $100.00 | $251.19 | $338.84 |
United Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Facility | None | $257.04 | $257.04 | $257.04 |
United Setting Professional Modifier None Typical Low $100.00 Median $251.19 Typical High $371.54 | Professional | None | $100.00 | $251.19 | $371.54 |
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 $151.36 Median $151.36 Typical High $151.36 | Facility | 52 · Reduced service | $151.36 | $151.36 | $151.36 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | 53 · Discontinued | $60.26 | $60.26 | $60.26 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $44.67 | Facility | 55 · Aftercare only | $44.67 | $44.67 | $44.67 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $30.20 | Facility | 56 · Pre-op care only | $30.20 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $128.82 Median $151.36 Typical High $151.36 | Professional | 52 · Reduced service | $128.82 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $51.29 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $44.67 Typical High $44.67 | Professional | 55 · Aftercare only | $38.02 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $30.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $25.70 | $30.20 | $30.20 |
Where Minnesota sits
The same service costs 4.1 times more in Alaska than in Montana. 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· 29th of 51
$257
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.