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 $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $52.48 Typical High $52.48 | Professional | None | $39.81 | $52.48 | $52.48 |
BCBS Minnesota Setting Facility Modifier None Typical Low $67.61 Median $74.13 Typical High $112.20 | Facility | None | $67.61 | $74.13 | $112.20 |
BCBS Minnesota Setting Professional Modifier None Typical Low $60.26 Median $75.86 Typical High $75.86 | Professional | None | $60.26 | $75.86 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $251.19 Typical High $645.65 | Facility | None | $48.98 | $251.19 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $91.20 Typical High $109.65 | Professional | None | $87.10 | $91.20 | $109.65 |
Health Partners Setting Facility Modifier None Typical Low $162.18 Median $257.04 Typical High $602.56 | Facility | None | $162.18 | $257.04 | $602.56 |
Health Partners Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
Medica Setting Facility Modifier None Typical Low $38.90 Median $74.13 Typical High $331.13 | Facility | None | $38.90 | $74.13 | $331.13 |
Medica Setting Professional Modifier None Typical Low $27.54 Median $33.88 Typical High $128.82 | Professional | None | $27.54 | $33.88 | $128.82 |
United Setting Facility Modifier None Typical Low $40.74 Median $52.48 Typical High $83.18 | Facility | None | $40.74 | $52.48 | $83.18 |
United Setting Professional Modifier None Typical Low $23.44 Median $33.88 Typical High $66.07 | Professional | None | $23.44 | $33.88 | $66.07 |
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 $25.70 Median $25.70 Typical High $25.70 | Facility | 52 · Reduced service | $25.70 | $25.70 | $25.70 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $10.47 Median $10.47 Typical High $10.47 | Facility | 53 · Discontinued | $10.47 | $10.47 | $10.47 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.76 Median $7.76 Typical High $7.76 | Facility | 55 · Aftercare only | $7.76 | $7.76 | $7.76 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.25 Typical High $5.25 | Facility | 56 · Pre-op care only | $5.25 | $5.25 | $5.25 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | 52 · Reduced service | $25.70 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | 53 · Discontinued | $10.47 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $7.76 Typical High $7.76 | Professional | 55 · Aftercare only | $7.76 | $7.76 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | 56 · Pre-op care only | $5.25 | $5.25 | $5.25 |
Where Minnesota sits
The same service costs 4.0 times more in Hawaii than in Washington, DC. 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· 5th of 51
$69.18
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.