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 $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $426.58 | Professional | None | $407.38 | $407.38 | $426.58 |
BCBS Minnesota Setting Facility Modifier None Typical Low $524.81 Median $588.84 Typical High $891.25 | Facility | None | $524.81 | $588.84 | $891.25 |
BCBS Minnesota Setting Professional Modifier None Typical Low $478.63 Median $602.56 Typical High $602.56 | Professional | None | $478.63 | $602.56 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $1,995.26 Typical High $5,128.61 | Facility | None | $338.84 | $1,995.26 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $724.44 Typical High $870.96 | Professional | None | $676.08 | $724.44 | $870.96 |
Health Partners Setting Facility Modifier None Typical Low $1,288.25 Median $2,041.74 Typical High $4,786.30 | Facility | None | $1,288.25 | $2,041.74 | $4,786.30 |
Health Partners Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
Medica Setting Facility Modifier None Typical Low $323.59 Median $588.84 Typical High $2,884.03 | Facility | None | $323.59 | $588.84 | $2,884.03 |
Medica Setting Professional Modifier None Typical Low $234.42 Median $295.12 Typical High $4,168.69 | Professional | None | $234.42 | $295.12 | $4,168.69 |
United Setting Facility Modifier None Typical Low $354.81 Median $407.38 Typical High $724.44 | Facility | None | $354.81 | $407.38 | $724.44 |
United Setting Professional Modifier None Typical Low $194.98 Median $295.12 Typical High $588.84 | Professional | None | $194.98 | $295.12 | $588.84 |
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 $204.17 Median $204.17 Typical High $204.17 | Facility | 52 · Reduced service | $204.17 | $204.17 | $204.17 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | 53 · Discontinued | $81.28 | $81.28 | $81.28 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | 55 · Aftercare only | $61.66 | $61.66 | $61.66 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $40.74 | Facility | 56 · Pre-op care only | $40.74 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $204.17 Typical High $213.80 | Professional | 52 · Reduced service | $204.17 | $204.17 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $85.11 | Professional | 53 · Discontinued | $81.28 | $81.28 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $64.57 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $42.66 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $42.66 |
Where Minnesota sits
The same service costs 4.2 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· 4th of 51
$575
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.