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 $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $70.79 | Professional | None | $69.18 | $69.18 | $70.79 |
BCBS Minnesota Setting Facility Modifier None Typical Low $89.13 Median $97.72 Typical High $151.36 | Facility | None | $89.13 | $97.72 | $151.36 |
BCBS Minnesota Setting Professional Modifier None Typical Low $79.43 Median $100.00 Typical High $100.00 | Professional | None | $79.43 | $100.00 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $338.84 Typical High $851.14 | Facility | None | $70.79 | $338.84 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $120.23 Typical High $144.54 | Professional | None | $114.82 | $120.23 | $144.54 |
Health Partners Setting Facility Modifier None Typical Low $213.80 Median $338.84 Typical High $794.33 | Facility | None | $213.80 | $338.84 | $794.33 |
Health Partners Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
Medica Setting Facility Modifier None Typical Low $42.66 Median $102.33 Typical High $457.09 | Facility | None | $42.66 | $102.33 | $457.09 |
Medica Setting Professional Modifier None Typical Low $38.90 Median $48.98 Typical High $489.78 | Professional | None | $38.90 | $48.98 | $489.78 |
United Setting Facility Modifier None Typical Low $102.33 Median $120.23 Typical High $144.54 | Facility | None | $102.33 | $120.23 | $144.54 |
United Setting Professional Modifier None Typical Low $32.36 Median $48.98 Typical High $95.50 | Professional | None | $32.36 | $48.98 | $95.50 |
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 $34.67 Median $34.67 Typical High $34.67 | Facility | 52 · Reduced service | $34.67 | $34.67 | $34.67 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $13.80 | Facility | 53 · Discontinued | $13.80 | $13.80 | $13.80 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.23 Median $10.23 Typical High $10.23 | Facility | 55 · Aftercare only | $10.23 | $10.23 | $10.23 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $6.92 | Facility | 56 · Pre-op care only | $6.92 | $6.92 | $6.92 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $34.67 Median $34.67 Typical High $35.48 | Professional | 52 · Reduced service | $34.67 | $34.67 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $14.45 | Professional | 53 · Discontinued | $13.80 | $13.80 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.23 Typical High $10.72 | Professional | 55 · Aftercare only | $10.23 | $10.23 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $7.08 | Professional | 56 · Pre-op care only | $6.92 | $6.92 | $7.08 |
Where Minnesota sits
The same service costs 2.0 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· 3rd of 51
$97.72
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.