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 $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $45.71 | Professional | None | $43.65 | $43.65 | $45.71 |
BCBS Minnesota Setting Facility Modifier None Typical Low $57.54 Median $63.10 Typical High $95.50 | Facility | None | $57.54 | $63.10 | $95.50 |
BCBS Minnesota Setting Professional Modifier None Typical Low $51.29 Median $64.57 Typical High $64.57 | Professional | None | $51.29 | $64.57 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $213.80 Typical High $549.54 | Facility | None | $40.74 | $213.80 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $77.62 Typical High $93.33 | Professional | None | $72.44 | $77.62 | $93.33 |
Health Partners Setting Facility Modifier None Typical Low $138.04 Median $218.78 Typical High $512.86 | Facility | None | $138.04 | $218.78 | $512.86 |
Health Partners Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
Medica Setting Facility Modifier None Typical Low $38.02 Median $66.07 Typical High $323.59 | Facility | None | $38.02 | $66.07 | $323.59 |
Medica Setting Professional Modifier None Typical Low $25.12 Median $34.67 Typical High $398.11 | Professional | None | $25.12 | $34.67 | $398.11 |
United Setting Facility Modifier None Typical Low $36.31 Median $40.74 Typical High $85.11 | Facility | None | $36.31 | $40.74 | $85.11 |
United Setting Professional Modifier None Typical Low $20.89 Median $34.67 Typical High $67.61 | Professional | None | $20.89 | $34.67 | $67.61 |
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 $21.88 Median $21.88 Typical High $21.88 | Facility | 52 · Reduced service | $21.88 | $21.88 | $21.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $8.91 Median $8.91 Typical High $8.91 | Facility | 53 · Discontinued | $8.91 | $8.91 | $8.91 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $6.61 | Facility | 55 · Aftercare only | $6.61 | $6.61 | $6.61 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $4.37 | Facility | 56 · Pre-op care only | $4.37 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $21.88 Median $21.88 Typical High $22.91 | Professional | 52 · Reduced service | $21.88 | $21.88 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $8.91 Typical High $9.12 | Professional | 53 · Discontinued | $8.91 | $8.91 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $6.92 | Professional | 55 · Aftercare only | $6.61 | $6.61 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $4.57 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $4.57 |
Where Minnesota sits
The same service costs 2.7 times more in Montana 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· 9th of 51
$63.10
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.