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 $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $69.18 | Professional | None | $66.07 | $66.07 | $69.18 |
BCBS Minnesota Setting Facility Modifier None Typical Low $85.11 Median $93.33 Typical High $144.54 | Facility | None | $85.11 | $93.33 | $144.54 |
BCBS Minnesota Setting Professional Modifier None Typical Low $77.62 Median $95.50 Typical High $95.50 | Professional | None | $77.62 | $95.50 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $316.23 Typical High $812.83 | Facility | None | $58.88 | $316.23 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $114.82 Typical High $138.04 | Professional | None | $109.65 | $114.82 | $138.04 |
Health Partners Setting Facility Modifier None Typical Low $204.17 Median $323.59 Typical High $776.25 | Facility | None | $204.17 | $323.59 | $776.25 |
Health Partners Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Medica Setting Facility Modifier None Typical Low $52.48 Median $100.00 Typical High $478.63 | Facility | None | $52.48 | $100.00 | $478.63 |
Medica Setting Professional Modifier None Typical Low $37.15 Median $52.48 Typical High $616.60 | Professional | None | $37.15 | $52.48 | $616.60 |
United Setting Facility Modifier None Typical Low $40.74 Median $46.77 Typical High $128.82 | Facility | None | $40.74 | $46.77 | $128.82 |
United Setting Professional Modifier None Typical Low $31.62 Median $51.29 Typical High $102.33 | Professional | None | $31.62 | $51.29 | $102.33 |
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 $33.11 Median $33.11 Typical High $33.11 | Facility | 52 · Reduced service | $33.11 | $33.11 | $33.11 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $13.18 Median $13.18 Typical High $13.18 | Facility | 53 · Discontinued | $13.18 | $13.18 | $13.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $10.00 | Facility | 55 · Aftercare only | $10.00 | $10.00 | $10.00 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.61 Typical High $6.61 | Facility | 56 · Pre-op care only | $6.61 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $33.11 Typical High $33.88 | Professional | 52 · Reduced service | $33.11 | $33.11 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $13.18 Typical High $13.80 | Professional | 53 · Discontinued | $13.18 | $13.18 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $10.23 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.61 Typical High $6.92 | Professional | 56 · Pre-op care only | $6.61 | $6.61 | $6.92 |
Where Minnesota sits
The same service costs 2.5 times more in Arkansas 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
$93.33
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.