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 $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $36.31 Typical High $36.31 | Professional | None | $30.90 | $36.31 | $36.31 |
BCBS Minnesota Setting Facility Modifier None Typical Low $46.77 Median $52.48 Typical High $79.43 | Facility | None | $46.77 | $52.48 | $79.43 |
BCBS Minnesota Setting Professional Modifier None Typical Low $42.66 Median $53.70 Typical High $53.70 | Professional | None | $42.66 | $53.70 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $177.83 Typical High $446.68 | Facility | None | $34.67 | $177.83 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $64.57 Typical High $75.86 | Professional | None | $60.26 | $64.57 | $75.86 |
Health Partners Setting Facility Modifier None Typical Low $112.20 Median $181.97 Typical High $426.58 | Facility | None | $112.20 | $181.97 | $426.58 |
Health Partners Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Medica Setting Facility Modifier None Typical Low $15.85 Median $52.48 Typical High $239.88 | Facility | None | $15.85 | $52.48 | $239.88 |
Medica Setting Professional Modifier None Typical Low $20.89 Median $25.70 Typical High $263.03 | Professional | None | $20.89 | $25.70 | $263.03 |
United Setting Facility Modifier None Typical Low $53.70 Median $63.10 Typical High $75.86 | Facility | None | $53.70 | $63.10 | $75.86 |
United Setting Professional Modifier None Typical Low $17.38 Median $25.70 Typical High $50.12 | Professional | None | $17.38 | $25.70 | $50.12 |
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 $18.20 Median $18.20 Typical High $18.20 | Facility | 52 · Reduced service | $18.20 | $18.20 | $18.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $7.24 Median $7.24 Typical High $7.24 | Facility | 53 · Discontinued | $7.24 | $7.24 | $7.24 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.50 Median $5.50 Typical High $5.50 | Facility | 55 · Aftercare only | $5.50 | $5.50 | $5.50 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $3.63 | Facility | 56 · Pre-op care only | $3.63 | $3.63 | $3.63 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $18.20 Median $18.20 Typical High $19.05 | Professional | 52 · Reduced service | $18.20 | $18.20 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.24 Typical High $7.59 | Professional | 53 · Discontinued | $7.24 | $7.24 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.50 Typical High $5.75 | Professional | 55 · Aftercare only | $5.50 | $5.50 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $3.80 | Professional | 56 · Pre-op care only | $3.63 | $3.63 | $3.80 |
Where Minnesota sits
The same service costs 2.1 times more in Montana than in New Jersey. 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
$50.12
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.