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 $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $25.70 | Professional | None | $24.55 | $24.55 | $25.70 |
BCBS Minnesota Setting Facility Modifier None Typical Low $31.62 Median $35.48 Typical High $53.70 | Facility | None | $31.62 | $35.48 | $53.70 |
BCBS Minnesota Setting Professional Modifier None Typical Low $28.84 Median $36.31 Typical High $36.31 | Professional | None | $28.84 | $36.31 | $36.31 |
Cigna Setting Facility Modifier None Typical Low $24.55 Median $120.23 Typical High $302.00 | Facility | None | $24.55 | $120.23 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $43.65 Typical High $52.48 | Professional | None | $40.74 | $43.65 | $52.48 |
Health Partners Setting Facility Modifier None Typical Low $77.62 Median $123.03 Typical High $288.40 | Facility | None | $77.62 | $123.03 | $288.40 |
Health Partners Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
Medica Setting Facility Modifier None Typical Low $15.14 Median $35.48 Typical High $165.96 | Facility | None | $15.14 | $35.48 | $165.96 |
Medica Setting Professional Modifier None Typical Low $14.13 Median $17.38 Typical High $177.83 | Professional | None | $14.13 | $17.38 | $177.83 |
United Setting Facility Modifier None Typical Low $36.31 Median $42.66 Typical High $51.29 | Facility | None | $36.31 | $42.66 | $51.29 |
United Setting Professional Modifier None Typical Low $11.75 Median $17.38 Typical High $33.88 | Professional | None | $11.75 | $17.38 | $33.88 |
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 $12.30 Median $12.30 Typical High $12.30 | Facility | 52 · Reduced service | $12.30 | $12.30 | $12.30 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $4.90 Median $4.90 Typical High $4.90 | Facility | 53 · Discontinued | $4.90 | $4.90 | $4.90 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $3.72 | Facility | 55 · Aftercare only | $3.72 | $3.72 | $3.72 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $2.45 | Facility | 56 · Pre-op care only | $2.45 | $2.45 | $2.45 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.30 Median $12.30 Typical High $12.88 | Professional | 52 · Reduced service | $12.30 | $12.30 | $12.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $4.90 Typical High $5.13 | Professional | 53 · Discontinued | $4.90 | $4.90 | $5.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $3.89 | Professional | 55 · Aftercare only | $3.72 | $3.72 | $3.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $2.57 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $2.57 |
Where Minnesota sits
The same service costs 2.1 times more in Montana 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· 2nd of 51
$35.48
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.