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 $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $57.54 Typical High $57.54 | Professional | None | $51.29 | $57.54 | $57.54 |
BCBS Minnesota Setting Facility Modifier None Typical Low $74.13 Median $81.28 Typical High $123.03 | Facility | None | $74.13 | $81.28 | $123.03 |
BCBS Minnesota Setting Professional Modifier None Typical Low $66.07 Median $83.18 Typical High $83.18 | Professional | None | $66.07 | $83.18 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $281.84 Typical High $707.95 | Facility | None | $56.23 | $281.84 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $100.00 Typical High $120.23 | Professional | None | $95.50 | $100.00 | $120.23 |
Health Partners Setting Facility Modifier None Typical Low $177.83 Median $281.84 Typical High $660.69 | Facility | None | $177.83 | $281.84 | $660.69 |
Health Partners Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
Medica Setting Facility Modifier None Typical Low $28.18 Median $81.28 Typical High $363.08 | Facility | None | $28.18 | $81.28 | $363.08 |
Medica Setting Professional Modifier None Typical Low $29.51 Median $36.31 Typical High $489.78 | Professional | None | $29.51 | $36.31 | $489.78 |
United Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $89.13 | Facility | None | $43.65 | $43.65 | $89.13 |
United Setting Professional Modifier None Typical Low $25.70 Median $36.31 Typical High $72.44 | Professional | None | $25.70 | $36.31 | $72.44 |
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 $28.18 Median $28.18 Typical High $28.18 | Facility | 52 · Reduced service | $28.18 | $28.18 | $28.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $11.48 | Facility | 53 · Discontinued | $11.48 | $11.48 | $11.48 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $8.51 | Facility | 55 · Aftercare only | $8.51 | $8.51 | $8.51 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.75 Typical High $5.75 | Facility | 56 · Pre-op care only | $5.75 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | 52 · Reduced service | $28.18 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | 53 · Discontinued | $11.48 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | 56 · Pre-op care only | $5.75 | $5.75 | $5.75 |
Where Minnesota sits
The same service costs 3.1 times more in Hawaii than in Kentucky. 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
$79.43
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.