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 $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $134.90 | Professional | None | $128.82 | $128.82 | $134.90 |
BCBS Setting Facility Modifier None Typical Low $165.96 Median $186.21 Typical High $281.84 | Facility | None | $165.96 | $186.21 | $281.84 |
BCBS Setting Professional Modifier None Typical Low $151.36 Median $190.55 Typical High $190.55 | Professional | None | $151.36 | $190.55 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $630.96 Typical High $1,621.81 | Facility | None | $120.23 | $630.96 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $229.09 Typical High $275.42 | Professional | None | $213.80 | $229.09 | $275.42 |
Health Partners Setting Facility Modifier None Typical Low $407.38 Median $645.65 Typical High $1,513.56 | Facility | None | $407.38 | $645.65 | $1,513.56 |
Health Partners Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
Medica Setting Facility Modifier None Typical Low $95.50 Median $194.98 Typical High $870.96 | Facility | None | $95.50 | $194.98 | $870.96 |
Medica Setting Professional Modifier None Typical Low $74.13 Median $93.33 Typical High $1,000.00 | Professional | None | $74.13 | $93.33 | $1,000.00 |
United Setting Facility Modifier None Typical Low $72.44 Median $85.11 Typical High $229.09 | Facility | None | $72.44 | $85.11 | $229.09 |
United Setting Professional Modifier None Typical Low $61.66 Median $93.33 Typical High $186.21 | Professional | None | $61.66 | $93.33 | $186.21 |
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 $64.57 Median $64.57 Typical High $64.57 | Facility | 52 · Reduced service | $64.57 | $64.57 | $64.57 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $25.70 Median $25.70 Typical High $25.70 | Facility | 53 · Discontinued | $25.70 | $25.70 | $25.70 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.50 Median $19.50 Typical High $19.50 | Facility | 55 · Aftercare only | $19.50 | $19.50 | $19.50 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.88 Median $12.88 Typical High $12.88 | Facility | 56 · Pre-op care only | $12.88 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $64.57 Median $64.57 Typical High $67.61 | Professional | 52 · Reduced service | $64.57 | $64.57 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $25.70 Typical High $26.92 | Professional | 53 · Discontinued | $25.70 | $25.70 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.50 Typical High $20.42 | Professional | 55 · Aftercare only | $19.50 | $19.50 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $12.88 Typical High $13.49 | Professional | 56 · Pre-op care only | $12.88 | $12.88 | $13.49 |
Where Minnesota sits
The same service costs 2.4 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· 4th of 51
$182
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.