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 $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $34.67 Median $42.66 Typical High $44.67 | Professional | None | $34.67 | $42.66 | $44.67 |
BCBS Minnesota Setting Facility Modifier None Typical Low $54.95 Median $61.66 Typical High $93.33 | Facility | None | $54.95 | $61.66 | $93.33 |
BCBS Minnesota Setting Professional Modifier None Typical Low $50.12 Median $63.10 Typical High $63.10 | Professional | None | $50.12 | $63.10 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $208.93 Typical High $524.81 | Facility | None | $33.88 | $208.93 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $75.86 Typical High $89.13 | Professional | None | $70.79 | $75.86 | $89.13 |
Health Partners Setting Facility Modifier None Typical Low $131.83 Median $213.80 Typical High $501.19 | Facility | None | $131.83 | $213.80 | $501.19 |
Health Partners Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
Medica Setting Facility Modifier None Typical Low $19.95 Median $61.66 Typical High $288.40 | Facility | None | $19.95 | $61.66 | $288.40 |
Medica Setting Professional Modifier None Typical Low $24.55 Median $30.20 Typical High $117.49 | Professional | None | $24.55 | $30.20 | $117.49 |
United Setting Facility Modifier None Typical Low $63.10 Median $74.13 Typical High $89.13 | Facility | None | $63.10 | $74.13 | $89.13 |
United Setting Professional Modifier None Typical Low $20.42 Median $30.20 Typical High $60.26 | Professional | None | $20.42 | $30.20 | $60.26 |
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 $21.38 Median $21.38 Typical High $21.38 | Facility | 52 · Reduced service | $21.38 | $21.38 | $21.38 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $8.51 Median $8.51 Typical High $8.51 | Facility | 53 · Discontinued | $8.51 | $8.51 | $8.51 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $6.46 | Facility | 55 · Aftercare only | $6.46 | $6.46 | $6.46 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $4.27 | Facility | 56 · Pre-op care only | $4.27 | $4.27 | $4.27 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $21.38 Median $21.38 Typical High $22.39 | Professional | 52 · Reduced service | $21.38 | $21.38 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.51 Typical High $8.91 | Professional | 53 · Discontinued | $8.51 | $8.51 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $6.76 | Professional | 55 · Aftercare only | $6.46 | $6.46 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $4.47 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $4.47 |
Where Minnesota sits
The same service costs 2.8 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
$58.88
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.