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 $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $109.65 Typical High $114.82 | Professional | None | $89.13 | $109.65 | $114.82 |
BCBS Minnesota Setting Facility Modifier None Typical Low $141.25 Median $158.49 Typical High $239.88 | Facility | None | $141.25 | $158.49 | $239.88 |
BCBS Minnesota Setting Professional Modifier None Typical Low $128.82 Median $158.49 Typical High $158.49 | Professional | None | $128.82 | $158.49 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $537.03 Typical High $1,348.96 | Facility | None | $102.33 | $537.03 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $194.98 Typical High $229.09 | Professional | None | $181.97 | $194.98 | $229.09 |
Health Partners Setting Facility Modifier None Typical Low $338.84 Median $549.54 Typical High $1,288.25 | Facility | None | $338.84 | $549.54 | $1,288.25 |
Health Partners Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
Medica Setting Facility Modifier None Typical Low $85.11 Median $165.96 Typical High $741.31 | Facility | None | $85.11 | $165.96 | $741.31 |
Medica Setting Professional Modifier None Typical Low $63.10 Median $77.62 Typical High $302.00 | Professional | None | $63.10 | $77.62 | $302.00 |
United Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $190.55 | Facility | None | $87.10 | $87.10 | $190.55 |
United Setting Professional Modifier None Typical Low $52.48 Median $77.62 Typical High $154.88 | Professional | None | $52.48 | $77.62 | $154.88 |
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 $54.95 Median $54.95 Typical High $54.95 | Facility | 52 · Reduced service | $54.95 | $54.95 | $54.95 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $21.88 | Facility | 53 · Discontinued | $21.88 | $21.88 | $21.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.60 Median $16.60 Typical High $16.60 | Facility | 55 · Aftercare only | $16.60 | $16.60 | $16.60 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $10.96 | Facility | 56 · Pre-op care only | $10.96 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $54.95 Typical High $57.54 | Professional | 52 · Reduced service | $54.95 | $54.95 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $22.91 | Professional | 53 · Discontinued | $21.88 | $21.88 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $16.60 Typical High $17.38 | Professional | 55 · Aftercare only | $16.60 | $16.60 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $11.48 | Professional | 56 · Pre-op care only | $10.96 | $10.96 | $11.48 |
Where Minnesota sits
The same service costs 2.9 times more in Hawaii than in New Jersey. 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· 10th of 51
$151
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.