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 $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $478.63 Typical High $489.78 | Professional | None | $416.87 | $478.63 | $489.78 |
BCBS Minnesota Setting Facility Modifier None Typical Low $616.60 Median $676.08 Typical High $1,047.13 | Facility | None | $616.60 | $676.08 | $1,047.13 |
BCBS Minnesota Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $691.83 | Professional | None | $549.54 | $691.83 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $2,344.23 Typical High $5,888.44 | Facility | None | $416.87 | $2,344.23 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $831.76 Typical High $1,000.00 | Professional | None | $794.33 | $831.76 | $1,000.00 |
Health Partners Setting Facility Modifier None Typical Low $1,479.11 Median $2,344.23 Typical High $5,495.41 | Facility | None | $1,479.11 | $2,344.23 | $5,495.41 |
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 $457.09 Median $707.95 Typical High $3,162.28 | Facility | None | $457.09 | $707.95 | $3,162.28 |
Medica Setting Professional Modifier None Typical Low $269.15 Median $338.84 Typical High $1,288.25 | Professional | None | $269.15 | $338.84 | $1,288.25 |
United Setting Facility Modifier None Typical Low $707.95 Median $831.76 Typical High $977.24 | Facility | None | $707.95 | $831.76 | $977.24 |
United Setting Professional Modifier None Typical Low $223.87 Median $338.84 Typical High $660.69 | Professional | None | $223.87 | $338.84 | $660.69 |
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 $95.50 Median $95.50 Typical High $95.50 | Facility | 53 · Discontinued | $95.50 | $95.50 | $95.50 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | 55 · Aftercare only | $70.79 | $70.79 | $70.79 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $47.86 | Facility | 56 · Pre-op care only | $47.86 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $239.88 Median $239.88 Typical High $245.47 | Professional | 52 · Reduced service | $239.88 | $239.88 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $100.00 | Professional | 53 · Discontinued | $95.50 | $95.50 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $74.13 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $48.98 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $48.98 |
Where Minnesota sits
The same service costs 2.2 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· 6th of 51
$661
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.