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 $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $501.19 | Professional | None | $489.78 | $489.78 | $501.19 |
BCBS Minnesota Setting Facility Modifier None Typical Low $630.96 Median $691.83 Typical High $1,047.13 | Facility | None | $630.96 | $691.83 | $1,047.13 |
BCBS Minnesota Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $707.95 | Professional | None | $562.34 | $707.95 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $2,398.83 Typical High $6,025.60 | Facility | None | $436.52 | $2,398.83 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $851.14 Typical High $1,023.29 | Professional | None | $794.33 | $851.14 | $1,023.29 |
Health Partners Setting Facility Modifier None Typical Low $1,513.56 Median $2,398.83 Typical High $5,623.41 | Facility | None | $1,513.56 | $2,398.83 | $5,623.41 |
Health Partners Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
Medica Setting Facility Modifier None Typical Low $467.74 Median $724.44 Typical High $3,235.94 | Facility | None | $467.74 | $724.44 | $3,235.94 |
Medica Setting Professional Modifier None Typical Low $275.42 Median $346.74 Typical High $3,467.37 | Professional | None | $275.42 | $346.74 | $3,467.37 |
United Setting Facility Modifier None Typical Low $707.95 Median $851.14 Typical High $1,000.00 | Facility | None | $707.95 | $851.14 | $1,000.00 |
United Setting Professional Modifier None Typical Low $229.09 Median $346.74 Typical High $676.08 | Professional | None | $229.09 | $346.74 | $676.08 |
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 $239.88 Median $239.88 Typical High $239.88 | Facility | 52 · Reduced service | $239.88 | $239.88 | $239.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | 53 · Discontinued | $97.72 | $97.72 | $97.72 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | 55 · Aftercare only | $72.44 | $72.44 | $72.44 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $48.98 | Facility | 56 · Pre-op care only | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $239.88 Median $239.88 Typical High $251.19 | Professional | 52 · Reduced service | $239.88 | $239.88 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $102.33 | Professional | 53 · Discontinued | $97.72 | $97.72 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $75.86 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $50.12 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $50.12 |
Where Minnesota sits
The same service costs 2.3 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· 4th of 51
$692
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.