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 $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $85.11 | Professional | None | $81.28 | $81.28 | $85.11 |
BCBS Minnesota Setting Facility Modifier None Typical Low $104.71 Median $117.49 Typical High $177.83 | Facility | None | $104.71 | $117.49 | $177.83 |
BCBS Minnesota Setting Professional Modifier None Typical Low $95.50 Median $120.23 Typical High $120.23 | Professional | None | $95.50 | $120.23 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $398.11 Typical High $1,023.29 | Facility | None | $75.86 | $398.11 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $144.54 Typical High $173.78 | Professional | None | $134.90 | $144.54 | $173.78 |
Health Partners Setting Facility Modifier None Typical Low $257.04 Median $407.38 Typical High $954.99 | Facility | None | $257.04 | $407.38 | $954.99 |
Health Partners Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
Medica Setting Facility Modifier None Typical Low $70.79 Median $123.03 Typical High $602.56 | Facility | None | $70.79 | $123.03 | $602.56 |
Medica Setting Professional Modifier None Typical Low $46.77 Median $64.57 Typical High $794.33 | Professional | None | $46.77 | $64.57 | $794.33 |
United Setting Facility Modifier None Typical Low $77.62 Median $87.10 Typical High $158.49 | Facility | None | $77.62 | $87.10 | $158.49 |
United Setting Professional Modifier None Typical Low $38.90 Median $64.57 Typical High $125.89 | Professional | None | $38.90 | $64.57 | $125.89 |
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 $40.74 Median $40.74 Typical High $40.74 | Facility | 52 · Reduced service | $40.74 | $40.74 | $40.74 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $16.60 | Facility | 53 · Discontinued | $16.60 | $16.60 | $16.60 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $12.30 | Facility | 55 · Aftercare only | $12.30 | $12.30 | $12.30 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $8.13 | Facility | 56 · Pre-op care only | $8.13 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $40.74 Typical High $42.66 | Professional | 52 · Reduced service | $40.74 | $40.74 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $16.98 | Professional | 53 · Discontinued | $16.60 | $16.60 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $12.88 | Professional | 55 · Aftercare only | $12.30 | $12.30 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $8.51 | Professional | 56 · Pre-op care only | $8.13 | $8.13 | $8.51 |
Where Minnesota sits
The same service costs 4.4 times more in Kansas than in Vermont. 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· 10th of 51
$117
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.