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 $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $123.03 Typical High $128.82 | Professional | None | $100.00 | $123.03 | $128.82 |
BCBS Minnesota Setting Facility Modifier None Typical Low $158.49 Median $177.83 Typical High $269.15 | Facility | None | $158.49 | $177.83 | $269.15 |
BCBS Minnesota Setting Professional Modifier None Typical Low $144.54 Median $181.97 Typical High $181.97 | Professional | None | $144.54 | $181.97 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $602.56 Typical High $1,548.82 | Facility | None | $97.72 | $602.56 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $218.78 Typical High $263.03 | Professional | None | $204.17 | $218.78 | $263.03 |
Health Partners Setting Facility Modifier None Typical Low $389.05 Median $616.60 Typical High $1,445.44 | Facility | None | $389.05 | $616.60 | $1,445.44 |
Health Partners Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
Medica Setting Facility Modifier None Typical Low $91.20 Median $186.21 Typical High $812.83 | Facility | None | $91.20 | $186.21 | $812.83 |
Medica Setting Professional Modifier None Typical Low $70.79 Median $83.18 Typical High $1,000.00 | Professional | None | $70.79 | $83.18 | $1,000.00 |
United Setting Facility Modifier None Typical Low $95.50 Median $100.00 Typical High $204.17 | Facility | None | $95.50 | $100.00 | $204.17 |
United Setting Professional Modifier None Typical Low $58.88 Median $83.18 Typical High $165.96 | Professional | None | $58.88 | $83.18 | $165.96 |
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 $61.66 Median $61.66 Typical High $61.66 | Facility | 52 · Reduced service | $61.66 | $61.66 | $61.66 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $24.55 Median $24.55 Typical High $24.55 | Facility | 53 · Discontinued | $24.55 | $24.55 | $24.55 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $18.62 | Facility | 55 · Aftercare only | $18.62 | $18.62 | $18.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.30 Typical High $12.30 | Facility | 56 · Pre-op care only | $12.30 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $61.66 Median $61.66 Typical High $64.57 | Professional | 52 · Reduced service | $61.66 | $61.66 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $24.55 Typical High $25.70 | Professional | 53 · Discontinued | $24.55 | $24.55 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $19.50 | Professional | 55 · Aftercare only | $18.62 | $18.62 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.30 Typical High $12.88 | Professional | 56 · Pre-op care only | $12.30 | $12.30 | $12.88 |
Where Minnesota sits
The same service costs 3.2 times more in Hawaii than in Florida. 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· 8th of 51
$166
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.