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 $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $95.50 Typical High $100.00 | Professional | None | $87.10 | $95.50 | $100.00 |
BCBS Minnesota Setting Facility Modifier None Typical Low $123.03 Median $134.90 Typical High $208.93 | Facility | None | $123.03 | $134.90 | $208.93 |
BCBS Minnesota Setting Professional Modifier None Typical Low $109.65 Median $138.04 Typical High $138.04 | Professional | None | $109.65 | $138.04 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $446.68 Typical High $1,174.90 | Facility | None | $87.10 | $446.68 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $165.96 Typical High $199.53 | Professional | None | $158.49 | $165.96 | $199.53 |
Health Partners Setting Facility Modifier None Typical Low $295.12 Median $467.74 Typical High $1,096.48 | Facility | None | $295.12 | $467.74 | $1,096.48 |
Health Partners Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
Medica Setting Facility Modifier None Typical Low $57.54 Median $141.25 Typical High $724.44 | Facility | None | $57.54 | $141.25 | $724.44 |
Medica Setting Professional Modifier None Typical Low $53.70 Median $75.86 Typical High $1,288.25 | Professional | None | $53.70 | $75.86 | $1,288.25 |
United Setting Facility Modifier None Typical Low $91.20 Median $120.23 Typical High $186.21 | Facility | None | $91.20 | $120.23 | $186.21 |
United Setting Professional Modifier None Typical Low $44.67 Median $75.86 Typical High $144.54 | Professional | None | $44.67 | $75.86 | $144.54 |
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 $47.86 Median $47.86 Typical High $47.86 | Facility | 52 · Reduced service | $47.86 | $47.86 | $47.86 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $19.05 Median $19.05 Typical High $19.05 | Facility | 53 · Discontinued | $19.05 | $19.05 | $19.05 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $14.13 Median $14.13 Typical High $14.13 | Facility | 55 · Aftercare only | $14.13 | $14.13 | $14.13 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.55 Median $9.55 Typical High $9.55 | Facility | 56 · Pre-op care only | $9.55 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $47.86 Median $47.86 Typical High $48.98 | Professional | 52 · Reduced service | $47.86 | $47.86 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $19.05 Typical High $19.95 | Professional | 53 · Discontinued | $19.05 | $19.05 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $14.13 Typical High $14.79 | Professional | 55 · Aftercare only | $14.13 | $14.13 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $9.55 Typical High $10.00 | Professional | 56 · Pre-op care only | $9.55 | $9.55 | $10.00 |
Where Minnesota sits
The same service costs 5.0 times more in Hawaii 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
$132
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.