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 $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $54.95 | Professional | None | $53.70 | $53.70 | $54.95 |
BCBS Minnesota Setting Facility Modifier None Typical Low $69.18 Median $75.86 Typical High $117.49 | Facility | None | $69.18 | $75.86 | $117.49 |
BCBS Minnesota Setting Professional Modifier None Typical Low $61.66 Median $77.62 Typical High $77.62 | Professional | None | $61.66 | $77.62 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $257.04 Typical High $660.69 | Facility | None | $53.70 | $257.04 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $93.33 Typical High $112.20 | Professional | None | $89.13 | $93.33 | $112.20 |
Health Partners Setting Facility Modifier None Typical Low $165.96 Median $263.03 Typical High $616.60 | Facility | None | $165.96 | $263.03 | $616.60 |
Health Partners Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
Medica Setting Facility Modifier None Typical Low $33.11 Median $79.43 Typical High $398.11 | Facility | None | $33.11 | $79.43 | $398.11 |
Medica Setting Professional Modifier None Typical Low $30.20 Median $42.66 Typical High $501.19 | Professional | None | $30.20 | $42.66 | $501.19 |
United Setting Facility Modifier None Typical Low $47.86 Median $51.29 Typical High $104.71 | Facility | None | $47.86 | $51.29 | $104.71 |
United Setting Professional Modifier None Typical Low $25.12 Median $40.74 Typical High $81.28 | Professional | None | $25.12 | $40.74 | $81.28 |
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 $26.92 Median $26.92 Typical High $26.92 | Facility | 52 · Reduced service | $26.92 | $26.92 | $26.92 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $10.72 | Facility | 53 · Discontinued | $10.72 | $10.72 | $10.72 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.94 Median $7.94 Typical High $7.94 | Facility | 55 · Aftercare only | $7.94 | $7.94 | $7.94 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $5.37 | Facility | 56 · Pre-op care only | $5.37 | $5.37 | $5.37 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $26.92 Median $26.92 Typical High $27.54 | Professional | 52 · Reduced service | $26.92 | $26.92 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $11.22 | Professional | 53 · Discontinued | $10.72 | $10.72 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $7.94 Typical High $8.32 | Professional | 55 · Aftercare only | $7.94 | $7.94 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $5.50 | Professional | 56 · Pre-op care only | $5.37 | $5.37 | $5.50 |
Where Minnesota sits
The same service costs 3.1 times more in Hawaii than in West Virginia. 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· 9th of 51
$75.86
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.