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 $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $91.20 Typical High $91.20 | Professional | None | $77.62 | $91.20 | $91.20 |
BCBS Minnesota Setting Facility Modifier None Typical Low $117.49 Median $128.82 Typical High $194.98 | Facility | None | $117.49 | $128.82 | $194.98 |
BCBS Minnesota Setting Professional Modifier None Typical Low $104.71 Median $131.83 Typical High $131.83 | Professional | None | $104.71 | $131.83 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $426.58 Typical High $1,122.02 | Facility | None | $77.62 | $426.58 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $158.49 Typical High $190.55 | Professional | None | $151.36 | $158.49 | $190.55 |
Health Partners Setting Facility Modifier None Typical Low $281.84 Median $446.68 Typical High $1,047.13 | Facility | None | $281.84 | $446.68 | $1,047.13 |
Health Partners Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Medica Setting Facility Modifier None Typical Low $40.74 Median $131.83 Typical High $645.65 | Facility | None | $40.74 | $131.83 | $645.65 |
Medica Setting Professional Modifier None Typical Low $51.29 Median $67.61 Typical High $776.25 | Professional | None | $51.29 | $67.61 | $776.25 |
United Setting Facility Modifier None Typical Low $60.26 Median $81.28 Typical High $165.96 | Facility | None | $60.26 | $81.28 | $165.96 |
United Setting Professional Modifier None Typical Low $42.66 Median $67.61 Typical High $131.83 | Professional | None | $42.66 | $67.61 | $131.83 |
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 $44.67 Median $44.67 Typical High $44.67 | Facility | 52 · Reduced service | $44.67 | $44.67 | $44.67 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $18.20 Median $18.20 Typical High $18.20 | Facility | 53 · Discontinued | $18.20 | $18.20 | $18.20 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $13.49 | Facility | 55 · Aftercare only | $13.49 | $13.49 | $13.49 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $9.12 | Facility | 56 · Pre-op care only | $9.12 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $44.67 Median $44.67 Typical High $46.77 | Professional | 52 · Reduced service | $44.67 | $44.67 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.20 Typical High $18.62 | Professional | 53 · Discontinued | $18.20 | $18.20 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $14.13 | Professional | 55 · Aftercare only | $13.49 | $13.49 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $9.33 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $9.33 |
Where Minnesota sits
The same service costs 3.1 times more in Hawaii than in Delaware. 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· 4th of 51
$126
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.