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 $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
BCBS Minnesota Setting Facility Modifier None Typical Low $95.50 Median $107.15 Typical High $162.18 | Facility | None | $95.50 | $107.15 | $162.18 |
BCBS Minnesota Setting Professional Modifier None Typical Low $87.10 Median $109.65 Typical High $109.65 | Professional | None | $87.10 | $109.65 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $363.08 Typical High $933.25 | Facility | None | $66.07 | $363.08 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $131.83 Typical High $158.49 | Professional | None | $123.03 | $131.83 | $158.49 |
Health Partners Setting Facility Modifier None Typical Low $234.42 Median $371.54 Typical High $870.96 | Facility | None | $234.42 | $371.54 | $870.96 |
Health Partners Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
Medica Setting Facility Modifier None Typical Low $53.70 Median $107.15 Typical High $467.74 | Facility | None | $53.70 | $107.15 | $467.74 |
Medica Setting Professional Modifier None Typical Low $39.81 Median $48.98 Typical High $676.08 | Professional | None | $39.81 | $48.98 | $676.08 |
United Setting Facility Modifier None Typical Low $47.86 Median $58.88 Typical High $120.23 | Facility | None | $47.86 | $58.88 | $120.23 |
United Setting Professional Modifier None Typical Low $34.67 Median $48.98 Typical High $95.50 | Professional | None | $34.67 | $48.98 | $95.50 |
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 $37.15 Median $37.15 Typical High $37.15 | Facility | 52 · Reduced service | $37.15 | $37.15 | $37.15 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $14.79 Median $14.79 Typical High $14.79 | Facility | 53 · Discontinued | $14.79 | $14.79 | $14.79 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $11.22 | Facility | 55 · Aftercare only | $11.22 | $11.22 | $11.22 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.41 Typical High $7.41 | Facility | 56 · Pre-op care only | $7.41 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | 52 · Reduced service | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | 53 · Discontinued | $14.79 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | 55 · Aftercare only | $11.22 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | 56 · Pre-op care only | $7.41 | $7.41 | $7.41 |
Where Minnesota sits
The same service costs 3.4 times more in Hawaii 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· 4th of 51
$100
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.