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 $16.60 Median $56.23 Typical High $144.54 | Facility | None | $16.60 | $56.23 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $56.23 Typical High $58.88 | Professional | None | $41.69 | $56.23 | $58.88 |
BCBS Minnesota Setting Facility Modifier None Typical Low $72.44 Median $81.28 Typical High $123.03 | Facility | None | $72.44 | $81.28 | $123.03 |
BCBS Minnesota Setting Professional Modifier None Typical Low $66.07 Median $81.28 Typical High $81.28 | Professional | None | $66.07 | $81.28 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $45.71 Median $275.42 Typical High $691.83 | Facility | None | $45.71 | $275.42 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $100.00 Typical High $117.49 | Professional | None | $93.33 | $100.00 | $117.49 |
Health Partners Setting Facility Modifier None Typical Low $173.78 Median $281.84 Typical High $660.69 | Facility | None | $173.78 | $281.84 | $660.69 |
Health Partners Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Medica Setting Facility Modifier None Typical Low $21.88 Median $81.28 Typical High $354.81 | Facility | None | $21.88 | $81.28 | $354.81 |
Medica Setting Professional Modifier None Typical Low $30.20 Median $37.15 Typical High $141.25 | Professional | None | $30.20 | $37.15 | $141.25 |
United Setting Facility Modifier None Typical Low $43.65 Median $52.48 Typical High $89.13 | Facility | None | $43.65 | $52.48 | $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 $11.22 Median $11.22 Typical High $11.22 | Facility | 53 · Discontinued | $11.22 | $11.22 | $11.22 |
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 $5.62 Median $5.62 Typical High $5.62 | Facility | 56 · Pre-op care only | $5.62 | $5.62 | $5.62 |
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 $11.22 Median $11.22 Typical High $11.22 | Professional | 53 · Discontinued | $11.22 | $11.22 | $11.22 |
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 $5.62 Median $5.62 Typical High $5.62 | Professional | 56 · Pre-op care only | $5.62 | $5.62 | $5.62 |
Where Minnesota sits
The same service costs 3.8 times more in Hawaii 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· 6th of 51
$74.13
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.