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 $79.43 Median $95.50 Typical High $95.50 | Professional | None | $79.43 | $95.50 | $95.50 |
BCBS Minnesota Setting Facility Modifier None Typical Low $123.03 Median $138.04 Typical High $208.93 | Facility | None | $123.03 | $138.04 | $208.93 |
BCBS Minnesota Setting Professional Modifier None Typical Low $112.20 Median $141.25 Typical High $141.25 | Professional | None | $112.20 | $141.25 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $467.74 Typical High $1,202.26 | Facility | None | $64.57 | $467.74 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $169.82 Typical High $204.17 | Professional | None | $158.49 | $169.82 | $204.17 |
Health Partners Setting Facility Modifier None Typical Low $302.00 Median $478.63 Typical High $1,122.02 | Facility | None | $302.00 | $478.63 | $1,122.02 |
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 $63.10 Median $138.04 Typical High $549.54 | Facility | None | $63.10 | $138.04 | $549.54 |
Medica Setting Professional Modifier None Typical Low $46.77 Median $57.54 Typical High $645.65 | Professional | None | $46.77 | $57.54 | $645.65 |
United Setting Facility Modifier None Typical Low $50.12 Median $60.26 Typical High $141.25 | Facility | None | $50.12 | $60.26 | $141.25 |
United Setting Professional Modifier None Typical Low $40.74 Median $57.54 Typical High $117.49 | Professional | None | $40.74 | $57.54 | $117.49 |
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 $19.50 Median $19.50 Typical High $19.50 | Facility | 53 · Discontinued | $19.50 | $19.50 | $19.50 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $14.45 Median $14.45 Typical High $14.45 | Facility | 55 · Aftercare only | $14.45 | $14.45 | $14.45 |
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 $47.86 | Professional | 52 · Reduced service | $47.86 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | 53 · Discontinued | $19.50 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | 55 · Aftercare only | $14.45 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | 56 · Pre-op care only | $9.55 | $9.55 | $9.55 |
Where Minnesota sits
The same service costs 2.8 times more in Wisconsin 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· 3rd of 51
$126
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.