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 $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
BCBS Minnesota Setting Facility Modifier None Typical Low $100.00 Median $109.65 Typical High $165.96 | Facility | None | $100.00 | $109.65 | $165.96 |
BCBS Minnesota Setting Professional Modifier None Typical Low $89.13 Median $112.20 Typical High $112.20 | Professional | None | $89.13 | $112.20 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $371.54 Typical High $954.99 | Facility | None | $63.10 | $371.54 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $134.90 Typical High $162.18 | Professional | None | $125.89 | $134.90 | $162.18 |
Health Partners Setting Facility Modifier None Typical Low $239.88 Median $380.19 Typical High $891.25 | Facility | None | $239.88 | $380.19 | $891.25 |
Health Partners Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Medica Setting Facility Modifier None Typical Low $52.48 Median $112.20 Typical High $467.74 | Facility | None | $52.48 | $112.20 | $467.74 |
Medica Setting Professional Modifier None Typical Low $39.81 Median $48.98 Typical High $602.56 | Professional | None | $39.81 | $48.98 | $602.56 |
United Setting Facility Modifier None Typical Low $56.23 Median $58.88 Typical High $120.23 | Facility | None | $56.23 | $58.88 | $120.23 |
United Setting Professional Modifier None Typical Low $33.88 Median $48.98 Typical High $95.50 | Professional | None | $33.88 | $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 $38.02 Median $38.02 Typical High $38.02 | Facility | 52 · Reduced service | $38.02 | $38.02 | $38.02 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $15.49 Median $15.49 Typical High $15.49 | Facility | 53 · Discontinued | $15.49 | $15.49 | $15.49 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $11.48 | Facility | 55 · Aftercare only | $11.48 | $11.48 | $11.48 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $7.59 | Facility | 56 · Pre-op care only | $7.59 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | 52 · Reduced service | $38.02 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | 53 · Discontinued | $15.49 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | 55 · Aftercare only | $11.48 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $7.59 |
Where Minnesota sits
The same service costs 3.2 times more in Hawaii than in New Jersey. 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
$102
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.