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 $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $40.74 Typical High $40.74 | Professional | None | $37.15 | $40.74 | $40.74 |
BCBS Minnesota Setting Facility Modifier None Typical Low $67.61 Median $75.86 Typical High $144.54 | Facility | None | $67.61 | $75.86 | $144.54 |
BCBS Minnesota Setting Professional Modifier None Typical Low $63.10 Median $77.62 Typical High $77.62 | Professional | None | $63.10 | $77.62 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $199.53 Typical High $501.19 | Facility | None | $52.48 | $199.53 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $70.79 Typical High $85.11 | Professional | None | $67.61 | $70.79 | $85.11 |
Health Partners Setting Facility Modifier None Typical Low $125.89 Median $199.53 Typical High $467.74 | Facility | None | $125.89 | $199.53 | $467.74 |
Health Partners Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Medica Setting Facility Modifier None Typical Low $19.50 Median $60.26 Typical High $257.04 | Facility | None | $19.50 | $60.26 | $257.04 |
Medica Setting Professional Modifier None Typical Low $37.15 Median $46.77 Typical High $204.17 | Professional | None | $37.15 | $46.77 | $204.17 |
United Setting Facility Modifier None Typical Low $79.43 Median $93.33 Typical High $112.20 | Facility | None | $79.43 | $93.33 | $112.20 |
United Setting Professional Modifier None Typical Low $28.18 Median $46.77 Typical High $85.11 | Professional | None | $28.18 | $46.77 | $85.11 |
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 $20.42 Median $20.42 Typical High $20.42 | Facility | 52 · Reduced service | $20.42 | $20.42 | $20.42 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $8.13 Median $8.13 Typical High $8.13 | Facility | 53 · Discontinued | $8.13 | $8.13 | $8.13 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.03 Median $6.03 Typical High $6.03 | Facility | 55 · Aftercare only | $6.03 | $6.03 | $6.03 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.07 Typical High $4.07 | Facility | 56 · Pre-op care only | $4.07 | $4.07 | $4.07 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $19.50 Median $20.42 Typical High $20.42 | Professional | 52 · Reduced service | $19.50 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $8.13 Typical High $8.13 | Professional | 53 · Discontinued | $7.76 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $6.03 Typical High $6.03 | Professional | 55 · Aftercare only | $5.89 | $6.03 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $4.07 Typical High $4.07 | Professional | 56 · Pre-op care only | $3.89 | $4.07 | $4.07 |
Where Minnesota sits
The same service costs 2.6 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· 8th of 51
$67.61
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.