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 $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $60.26 | Professional | None | $56.23 | $56.23 | $60.26 |
BCBS Minnesota Setting Facility Modifier None Typical Low $47.86 Median $77.62 Typical High $104.71 | Facility | None | $47.86 | $77.62 | $104.71 |
BCBS Minnesota Setting Professional Modifier None Typical Low $44.67 Median $51.29 Typical High $56.23 | Professional | None | $44.67 | $51.29 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $144.54 Typical High $194.98 | Facility | None | $70.79 | $144.54 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $72.44 | Professional | None | $57.54 | $57.54 | $72.44 |
Health Partners Setting Facility Modifier None Typical Low $56.23 Median $138.04 Typical High $204.17 | Facility | None | $56.23 | $138.04 | $204.17 |
Health Partners Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
Medica Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $95.50 | Facility | None | $50.12 | $66.07 | $95.50 |
Medica Setting Professional Modifier None Typical Low $50.12 Median $56.23 Typical High $218.78 | Professional | None | $50.12 | $56.23 | $218.78 |
United Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
United Setting Professional Modifier None Typical Low $53.70 Median $56.23 Typical High $87.10 | Professional | None | $53.70 | $56.23 | $87.10 |
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 $28.18 Median $28.18 Typical High $28.18 | Facility | 52 · Reduced service | $28.18 | $28.18 | $28.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $11.22 Median $11.22 Typical High $11.22 | Facility | 53 · Discontinued | $11.22 | $11.22 | $11.22 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $8.51 | Facility | 55 · Aftercare only | $8.51 | $8.51 | $8.51 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $5.62 | Facility | 56 · Pre-op care only | $5.62 | $5.62 | $5.62 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $28.18 Median $28.18 Typical High $28.84 | Professional | 52 · Reduced service | $28.18 | $28.18 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.22 Typical High $11.75 | Professional | 53 · Discontinued | $11.22 | $11.22 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $8.71 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $5.75 | Professional | 56 · Pre-op care only | $5.62 | $5.62 | $5.75 |
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· 11th of 51
$57.54
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.