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 $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $67.61 | Professional | None | $64.57 | $64.57 | $67.61 |
BCBS Minnesota Setting Facility Modifier None Typical Low $83.18 Median $91.20 Typical High $141.25 | Facility | None | $83.18 | $91.20 | $141.25 |
BCBS Minnesota Setting Professional Modifier None Typical Low $75.86 Median $93.33 Typical High $93.33 | Professional | None | $75.86 | $93.33 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $316.23 Typical High $794.33 | Facility | None | $57.54 | $316.23 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $112.20 Typical High $134.90 | Professional | None | $107.15 | $112.20 | $134.90 |
Health Partners Setting Facility Modifier None Typical Low $199.53 Median $316.23 Typical High $758.58 | Facility | None | $199.53 | $316.23 | $758.58 |
Health Partners Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
Medica Setting Facility Modifier None Typical Low $33.88 Median $93.33 Typical High $426.58 | Facility | None | $33.88 | $93.33 | $426.58 |
Medica Setting Professional Modifier None Typical Low $36.31 Median $45.71 Typical High $467.74 | Professional | None | $36.31 | $45.71 | $467.74 |
United Setting Facility Modifier None Typical Low $95.50 Median $112.20 Typical High $134.90 | Facility | None | $95.50 | $112.20 | $134.90 |
United Setting Professional Modifier None Typical Low $30.90 Median $45.71 Typical High $89.13 | Professional | None | $30.90 | $45.71 | $89.13 |
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 $32.36 Median $32.36 Typical High $32.36 | Facility | 52 · Reduced service | $32.36 | $32.36 | $32.36 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.88 Median $12.88 Typical High $12.88 | Facility | 53 · Discontinued | $12.88 | $12.88 | $12.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.55 Median $9.55 Typical High $9.55 | Facility | 55 · Aftercare only | $9.55 | $9.55 | $9.55 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.46 Typical High $6.46 | Facility | 56 · Pre-op care only | $6.46 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $32.36 Typical High $33.88 | Professional | 52 · Reduced service | $32.36 | $32.36 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $12.88 Typical High $13.49 | Professional | 53 · Discontinued | $12.88 | $12.88 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $9.55 Typical High $10.00 | Professional | 55 · Aftercare only | $9.55 | $9.55 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.46 Typical High $6.76 | Professional | 56 · Pre-op care only | $6.46 | $6.46 | $6.76 |
Where Minnesota sits
The same service costs 2.3 times more in Montana than in Florida. 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
$91.20
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.