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 $257.04 Median $257.04 Typical High $257.04 | Facility | None | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $257.04 Typical High $257.04 | Professional | None | $234.42 | $257.04 | $257.04 |
BCBS Minnesota Setting Facility Modifier None Typical Low $426.58 Median $478.63 Typical High $870.96 | Facility | None | $426.58 | $478.63 | $870.96 |
BCBS Minnesota Setting Professional Modifier None Typical Low $389.05 Median $489.78 Typical High $489.78 | Professional | None | $389.05 | $489.78 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $1,258.93 Typical High $3,162.28 | Facility | None | $380.19 | $1,258.93 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $446.68 Typical High $537.03 | Professional | None | $426.58 | $446.68 | $537.03 |
Health Partners Setting Facility Modifier None Typical Low $794.33 Median $1,258.93 Typical High $3,019.95 | Facility | None | $794.33 | $1,258.93 | $3,019.95 |
Health Partners Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | None | $426.58 | $426.58 | $426.58 |
Medica Setting Facility Modifier None Typical Low $123.03 Median $389.05 Typical High $1,659.59 | Facility | None | $123.03 | $389.05 | $1,659.59 |
Medica Setting Professional Modifier None Typical Low $213.80 Median $288.40 Typical High $2,570.40 | Professional | None | $213.80 | $288.40 | $2,570.40 |
United Setting Facility Modifier None Typical Low $794.33 Median $933.25 Typical High $1,122.02 | Facility | None | $794.33 | $933.25 | $1,122.02 |
United Setting Professional Modifier None Typical Low $169.82 Median $288.40 Typical High $524.81 | Professional | None | $169.82 | $288.40 | $524.81 |
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 $128.82 Median $128.82 Typical High $128.82 | Facility | 52 · Reduced service | $128.82 | $128.82 | $128.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $51.29 Median $51.29 Typical High $51.29 | Facility | 53 · Discontinued | $51.29 | $51.29 | $51.29 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | 55 · Aftercare only | $38.90 | $38.90 | $38.90 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $25.70 | Facility | 56 · Pre-op care only | $25.70 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $117.49 Median $128.82 Typical High $128.82 | Professional | 52 · Reduced service | $117.49 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $51.29 Typical High $51.29 | Professional | 53 · Discontinued | $46.77 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $38.90 Typical High $38.90 | Professional | 55 · Aftercare only | $35.48 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $25.70 Typical High $25.70 | Professional | 56 · Pre-op care only | $23.44 | $25.70 | $25.70 |
Where Minnesota sits
The same service costs 3.0 times more in Hawaii than in Utah. 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
$427
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.