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 $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $64.57 | Professional | None | $61.66 | $61.66 | $64.57 |
BCBS Minnesota Setting Facility Modifier None Typical Low $81.28 Median $89.13 Typical High $134.90 | Facility | None | $81.28 | $89.13 | $134.90 |
BCBS Minnesota Setting Professional Modifier None Typical Low $72.44 Median $91.20 Typical High $91.20 | Professional | None | $72.44 | $91.20 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $309.03 Typical High $776.25 | Facility | None | $54.95 | $309.03 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $109.65 Typical High $131.83 | Professional | None | $102.33 | $109.65 | $131.83 |
Health Partners Setting Facility Modifier None Typical Low $194.98 Median $309.03 Typical High $724.44 | Facility | None | $194.98 | $309.03 | $724.44 |
Health Partners Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
Medica Setting Facility Modifier None Typical Low $33.11 Median $91.20 Typical High $416.87 | Facility | None | $33.11 | $91.20 | $416.87 |
Medica Setting Professional Modifier None Typical Low $35.48 Median $42.66 Typical High $562.34 | Professional | None | $35.48 | $42.66 | $562.34 |
United Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $104.71 | Facility | None | $51.29 | $51.29 | $104.71 |
United Setting Professional Modifier None Typical Low $29.51 Median $42.66 Typical High $83.18 | Professional | None | $29.51 | $42.66 | $83.18 |
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 $30.90 Median $30.90 Typical High $30.90 | Facility | 52 · Reduced service | $30.90 | $30.90 | $30.90 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.59 Median $12.59 Typical High $12.59 | Facility | 53 · Discontinued | $12.59 | $12.59 | $12.59 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.33 Median $9.33 Typical High $9.33 | Facility | 55 · Aftercare only | $9.33 | $9.33 | $9.33 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.17 Typical High $6.17 | Facility | 56 · Pre-op care only | $6.17 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.90 Median $30.90 Typical High $32.36 | Professional | 52 · Reduced service | $30.90 | $30.90 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $12.59 Typical High $12.88 | Professional | 53 · Discontinued | $12.59 | $12.59 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.33 Typical High $9.77 | Professional | 55 · Aftercare only | $9.33 | $9.33 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.17 Typical High $6.46 | Professional | 56 · Pre-op care only | $6.17 | $6.17 | $6.46 |
Where Minnesota sits
The same service costs 3.5 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· 8th of 51
$87.10
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.