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 $190.55 Median $190.55 Typical High $213.80 | Professional | None | $190.55 | $190.55 | $213.80 |
BCBS Minnesota Setting Facility Modifier None Typical Low $177.83 Median $363.08 Typical High $380.19 | Facility | None | $177.83 | $363.08 | $380.19 |
BCBS Minnesota Setting Professional Modifier None Typical Low $158.49 Median $186.21 Typical High $194.98 | Professional | None | $158.49 | $186.21 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $281.84 Typical High $588.84 | Facility | None | $229.09 | $281.84 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $199.53 Typical High $245.47 | Professional | None | $194.98 | $199.53 | $245.47 |
Health Partners Setting Facility Modifier None Typical Low $223.87 Median $251.19 Typical High $707.95 | Facility | None | $223.87 | $251.19 | $707.95 |
Health Partners Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
Medica Setting Facility Modifier None Typical Low $134.90 Median $181.97 Typical High $436.52 | Facility | None | $134.90 | $181.97 | $436.52 |
Medica Setting Professional Modifier None Typical Low $181.97 Median $194.98 Typical High $338.84 | Professional | None | $181.97 | $194.98 | $338.84 |
United Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
United Setting Professional Modifier None Typical Low $186.21 Median $194.98 Typical High $309.03 | Professional | None | $186.21 | $194.98 | $309.03 |
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 $95.50 Median $95.50 Typical High $97.72 | Professional | 52 · Reduced service | $95.50 | $95.50 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $38.90 | Professional | 53 · Discontinued | $38.02 | $38.02 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $29.51 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $19.50 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $19.50 |
Where Minnesota sits
Rates are fairly even across states for this service. 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· 13th of 51
$195
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.