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 $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $102.33 | Professional | None | $97.72 | $97.72 | $102.33 |
BCBS Minnesota Setting Facility Modifier None Typical Low $125.89 Median $138.04 Typical High $213.80 | Facility | None | $125.89 | $138.04 | $213.80 |
BCBS Minnesota Setting Professional Modifier None Typical Low $114.82 Median $141.25 Typical High $141.25 | Professional | None | $114.82 | $141.25 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $467.74 Typical High $1,202.26 | Facility | None | $91.20 | $467.74 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $169.82 Typical High $204.17 | Professional | None | $162.18 | $169.82 | $204.17 |
Health Partners Setting Facility Modifier None Typical Low $302.00 Median $478.63 Typical High $1,148.15 | Facility | None | $302.00 | $478.63 | $1,148.15 |
Health Partners Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
Medica Setting Facility Modifier None Typical Low $77.62 Median $147.91 Typical High $707.95 | Facility | None | $77.62 | $147.91 | $707.95 |
Medica Setting Professional Modifier None Typical Low $56.23 Median $77.62 Typical High $831.76 | Professional | None | $56.23 | $77.62 | $831.76 |
United Setting Facility Modifier None Typical Low $39.81 Median $69.18 Typical High $190.55 | Facility | None | $39.81 | $69.18 | $190.55 |
United Setting Professional Modifier None Typical Low $46.77 Median $75.86 Typical High $151.36 | Professional | None | $46.77 | $75.86 | $151.36 |
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 $48.98 Median $48.98 Typical High $48.98 | Facility | 52 · Reduced service | $48.98 | $48.98 | $48.98 |
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 $14.79 Median $14.79 Typical High $14.79 | Facility | 55 · Aftercare only | $14.79 | $14.79 | $14.79 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.77 Median $9.77 Typical High $9.77 | Facility | 56 · Pre-op care only | $9.77 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $48.98 Median $48.98 Typical High $51.29 | Professional | 52 · Reduced service | $48.98 | $48.98 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $19.50 Typical High $20.42 | Professional | 53 · Discontinued | $19.50 | $19.50 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $15.14 | Professional | 55 · Aftercare only | $14.79 | $14.79 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $9.77 Typical High $10.23 | Professional | 56 · Pre-op care only | $9.77 | $9.77 | $10.23 |
Where Minnesota sits
The same service costs 2.5 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· 7th of 51
$138
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.