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 $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $81.28 Typical High $85.11 | Professional | None | $67.61 | $81.28 | $85.11 |
BCBS Minnesota Setting Facility Modifier None Typical Low $104.71 Median $114.82 Typical High $177.83 | Facility | None | $104.71 | $114.82 | $177.83 |
BCBS Minnesota Setting Professional Modifier None Typical Low $95.50 Median $117.49 Typical High $117.49 | Professional | None | $95.50 | $117.49 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $398.11 Typical High $1,000.00 | Facility | None | $64.57 | $398.11 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $141.25 Typical High $169.82 | Professional | None | $134.90 | $141.25 | $169.82 |
Health Partners Setting Facility Modifier None Typical Low $251.19 Median $398.11 Typical High $954.99 | Facility | None | $251.19 | $398.11 | $954.99 |
Health Partners Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
Medica Setting Facility Modifier None Typical Low $50.12 Median $117.49 Typical High $537.03 | Facility | None | $50.12 | $117.49 | $537.03 |
Medica Setting Professional Modifier None Typical Low $45.71 Median $57.54 Typical High $588.84 | Professional | None | $45.71 | $57.54 | $588.84 |
United Setting Facility Modifier None Typical Low $120.23 Median $141.25 Typical High $169.82 | Facility | None | $120.23 | $141.25 | $169.82 |
United Setting Professional Modifier None Typical Low $38.90 Median $57.54 Typical High $112.20 | Professional | None | $38.90 | $57.54 | $112.20 |
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 $40.74 Median $40.74 Typical High $40.74 | Facility | 52 · Reduced service | $40.74 | $40.74 | $40.74 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $16.22 | Facility | 53 · Discontinued | $16.22 | $16.22 | $16.22 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $12.02 | Facility | 55 · Aftercare only | $12.02 | $12.02 | $12.02 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $8.13 | Facility | 56 · Pre-op care only | $8.13 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $40.74 Typical High $42.66 | Professional | 52 · Reduced service | $40.74 | $40.74 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $16.98 | Professional | 53 · Discontinued | $16.22 | $16.22 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $12.59 | Professional | 55 · Aftercare only | $12.02 | $12.02 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $8.51 | Professional | 56 · Pre-op care only | $8.13 | $8.13 | $8.51 |
Where Minnesota sits
The same service costs 2.6 times more in Hawaii than in Delaware. 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· 5th of 51
$112
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.