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 $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | None | $69.18 | $69.18 | $69.18 |
BCBS Minnesota Setting Facility Modifier None Typical Low $91.20 Median $100.00 Typical High $151.36 | Facility | None | $91.20 | $100.00 | $151.36 |
BCBS Minnesota Setting Professional Modifier None Typical Low $81.28 Median $102.33 Typical High $102.33 | Professional | None | $81.28 | $102.33 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $338.84 Typical High $870.96 | Facility | None | $64.57 | $338.84 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $123.03 Typical High $147.91 | Professional | None | $114.82 | $123.03 | $147.91 |
Health Partners Setting Facility Modifier None Typical Low $218.78 Median $346.74 Typical High $812.83 | Facility | None | $218.78 | $346.74 | $812.83 |
Health Partners Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
Medica Setting Facility Modifier None Typical Low $52.48 Median $100.00 Typical High $467.74 | Facility | None | $52.48 | $100.00 | $467.74 |
Medica Setting Professional Modifier None Typical Low $38.02 Median $47.86 Typical High $676.08 | Professional | None | $38.02 | $47.86 | $676.08 |
United Setting Facility Modifier None Typical Low $57.54 Median $60.26 Typical High $117.49 | Facility | None | $57.54 | $60.26 | $117.49 |
United Setting Professional Modifier None Typical Low $33.11 Median $47.86 Typical High $95.50 | Professional | None | $33.11 | $47.86 | $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 $34.67 Median $34.67 Typical High $34.67 | Facility | 52 · Reduced service | $34.67 | $34.67 | $34.67 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $14.13 Median $14.13 Typical High $14.13 | Facility | 53 · Discontinued | $14.13 | $14.13 | $14.13 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.47 Median $10.47 Typical High $10.47 | Facility | 55 · Aftercare only | $10.47 | $10.47 | $10.47 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $6.92 | Facility | 56 · Pre-op care only | $6.92 | $6.92 | $6.92 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | 52 · Reduced service | $34.67 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | 53 · Discontinued | $14.13 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | 55 · Aftercare only | $10.47 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | 56 · Pre-op care only | $6.92 | $6.92 | $6.92 |
Where Minnesota sits
The same service costs 3.5 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
$95.50
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.