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 $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $87.10 Typical High $87.10 | Professional | None | $70.79 | $87.10 | $87.10 |
BCBS Minnesota Setting Facility Modifier None Typical Low $112.20 Median $123.03 Typical High $190.55 | Facility | None | $112.20 | $123.03 | $190.55 |
BCBS Minnesota Setting Professional Modifier None Typical Low $102.33 Median $123.03 Typical High $125.89 | Professional | None | $102.33 | $123.03 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $407.38 Typical High $1,071.52 | Facility | None | $89.13 | $407.38 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $151.36 Typical High $181.97 | Professional | None | $144.54 | $151.36 | $181.97 |
Health Partners Setting Facility Modifier None Typical Low $269.15 Median $426.58 Typical High $1,023.29 | Facility | None | $269.15 | $426.58 | $1,023.29 |
Health Partners Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Medica Setting Facility Modifier None Typical Low $60.26 Median $123.03 Typical High $588.84 | Facility | None | $60.26 | $123.03 | $588.84 |
Medica Setting Professional Modifier None Typical Low $48.98 Median $61.66 Typical High $239.88 | Professional | None | $48.98 | $61.66 | $239.88 |
United Setting Facility Modifier None Typical Low $72.44 Median $75.86 Typical High $151.36 | Facility | None | $72.44 | $75.86 | $151.36 |
United Setting Professional Modifier None Typical Low $41.69 Median $61.66 Typical High $120.23 | Professional | None | $41.69 | $61.66 | $120.23 |
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 $43.65 Median $43.65 Typical High $43.65 | Facility | 52 · Reduced service | $43.65 | $43.65 | $43.65 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $17.38 Median $17.38 Typical High $17.38 | Facility | 53 · Discontinued | $17.38 | $17.38 | $17.38 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.88 Median $12.88 Typical High $12.88 | Facility | 55 · Aftercare only | $12.88 | $12.88 | $12.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $8.71 | Facility | 56 · Pre-op care only | $8.71 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | 52 · Reduced service | $43.65 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | 53 · Discontinued | $17.38 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | 55 · Aftercare only | $12.88 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | 56 · Pre-op care only | $8.71 | $8.71 | $8.71 |
Where Minnesota sits
The same service costs 2.8 times more in Hawaii than in Washington, DC. 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· 6th 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.