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 $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $39.81 Typical High $41.69 | Professional | None | $33.11 | $39.81 | $41.69 |
BCBS Minnesota Setting Facility Modifier None Typical Low $51.29 Median $56.23 Typical High $87.10 | Facility | None | $51.29 | $56.23 | $87.10 |
BCBS Minnesota Setting Professional Modifier None Typical Low $46.77 Median $56.23 Typical High $57.54 | Professional | None | $46.77 | $56.23 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $194.98 Typical High $489.78 | Facility | None | $33.11 | $194.98 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $69.18 Typical High $83.18 | Professional | None | $66.07 | $69.18 | $83.18 |
Health Partners Setting Facility Modifier None Typical Low $123.03 Median $194.98 Typical High $457.09 | Facility | None | $123.03 | $194.98 | $457.09 |
Health Partners Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | None | $66.07 | $66.07 | $66.07 |
Medica Setting Facility Modifier None Typical Low $26.92 Median $58.88 Typical High $263.03 | Facility | None | $26.92 | $58.88 | $263.03 |
Medica Setting Professional Modifier None Typical Low $22.39 Median $28.18 Typical High $288.40 | Professional | None | $22.39 | $28.18 | $288.40 |
United Setting Facility Modifier None Typical Low $58.88 Median $69.18 Typical High $83.18 | Facility | None | $58.88 | $69.18 | $83.18 |
United Setting Professional Modifier None Typical Low $19.05 Median $28.18 Typical High $54.95 | Professional | None | $19.05 | $28.18 | $54.95 |
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 $19.95 Median $19.95 Typical High $19.95 | Facility | 52 · Reduced service | $19.95 | $19.95 | $19.95 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $7.94 Median $7.94 Typical High $7.94 | Facility | 53 · Discontinued | $7.94 | $7.94 | $7.94 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.03 Median $6.03 Typical High $6.03 | Facility | 55 · Aftercare only | $6.03 | $6.03 | $6.03 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.98 Median $3.98 Typical High $3.98 | Facility | 56 · Pre-op care only | $3.98 | $3.98 | $3.98 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $19.95 Median $19.95 Typical High $20.89 | Professional | 52 · Reduced service | $19.95 | $19.95 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $7.94 Typical High $8.32 | Professional | 53 · Discontinued | $7.94 | $7.94 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.03 Typical High $6.17 | Professional | 55 · Aftercare only | $6.03 | $6.03 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $3.98 Typical High $4.17 | Professional | 56 · Pre-op care only | $3.98 | $3.98 | $4.17 |
Where Minnesota sits
The same service costs 2.6 times more in Montana than in Kansas. 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· 6th of 51
$54.95
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.