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 $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $141.25 | Professional | None | $134.90 | $134.90 | $141.25 |
BCBS Minnesota Setting Facility Modifier None Typical Low $177.83 Median $194.98 Typical High $295.12 | Facility | None | $177.83 | $194.98 | $295.12 |
BCBS Minnesota Setting Professional Modifier None Typical Low $158.49 Median $194.98 Typical High $199.53 | Professional | None | $158.49 | $194.98 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $676.08 Typical High $1,698.24 | Facility | None | $128.82 | $676.08 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $239.88 Typical High $288.40 | Professional | None | $223.87 | $239.88 | $288.40 |
Health Partners Setting Facility Modifier None Typical Low $426.58 Median $676.08 Typical High $1,584.89 | Facility | None | $426.58 | $676.08 | $1,584.89 |
Health Partners Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
Medica Setting Facility Modifier None Typical Low $75.86 Median $194.98 Typical High $912.01 | Facility | None | $75.86 | $194.98 | $912.01 |
Medica Setting Professional Modifier None Typical Low $77.62 Median $95.50 Typical High $977.24 | Professional | None | $77.62 | $95.50 | $977.24 |
United Setting Facility Modifier None Typical Low $199.53 Median $234.42 Typical High $281.84 | Facility | None | $199.53 | $234.42 | $281.84 |
United Setting Professional Modifier None Typical Low $64.57 Median $95.50 Typical High $190.55 | Professional | None | $64.57 | $95.50 | $190.55 |
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 $67.61 Median $67.61 Typical High $67.61 | Facility | 52 · Reduced service | $67.61 | $67.61 | $67.61 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $27.54 Median $27.54 Typical High $27.54 | Facility | 53 · Discontinued | $27.54 | $27.54 | $27.54 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $20.42 Median $20.42 Typical High $20.42 | Facility | 55 · Aftercare only | $20.42 | $20.42 | $20.42 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.49 Typical High $13.49 | Facility | 56 · Pre-op care only | $13.49 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $67.61 Median $67.61 Typical High $70.79 | Professional | 52 · Reduced service | $67.61 | $67.61 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $27.54 Typical High $28.18 | Professional | 53 · Discontinued | $27.54 | $27.54 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $20.42 Typical High $21.38 | Professional | 55 · Aftercare only | $20.42 | $20.42 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.49 Typical High $14.13 | Professional | 56 · Pre-op care only | $13.49 | $13.49 | $14.13 |
Where Minnesota sits
The same service costs 2.5 times more in Kansas than in Utah. 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· 4th of 51
$195
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.