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 $57.54 Median $74.13 Typical High $83.18 | Facility | None | $57.54 | $74.13 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $74.13 Typical High $77.62 | Professional | None | $63.10 | $74.13 | $77.62 |
BCBS Setting Facility Modifier None Typical Low $95.50 Median $104.71 Typical High $162.18 | Facility | None | $95.50 | $104.71 | $162.18 |
BCBS Setting Professional Modifier None Typical Low $87.10 Median $107.15 Typical High $107.15 | Professional | None | $87.10 | $107.15 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $363.08 Typical High $912.01 | Facility | None | $61.66 | $363.08 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $128.82 Typical High $154.88 | Professional | None | $123.03 | $128.82 | $154.88 |
Health Partners Setting Facility Modifier None Typical Low $229.09 Median $363.08 Typical High $870.96 | Facility | None | $229.09 | $363.08 | $870.96 |
Health Partners Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
Medica Setting Facility Modifier None Typical Low $70.79 Median $104.71 Typical High $478.63 | Facility | None | $70.79 | $104.71 | $478.63 |
Medica Setting Professional Modifier None Typical Low $40.74 Median $53.70 Typical High $204.17 | Professional | None | $40.74 | $53.70 | $204.17 |
United Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $131.83 | Facility | None | $72.44 | $72.44 | $131.83 |
United Setting Professional Modifier None Typical Low $35.48 Median $53.70 Typical High $104.71 | Professional | None | $35.48 | $53.70 | $104.71 |
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 $37.15 Median $37.15 Typical High $37.15 | Facility | 52 · Reduced service | $37.15 | $37.15 | $37.15 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $14.79 Median $14.79 Typical High $14.79 | Facility | 53 · Discontinued | $14.79 | $14.79 | $14.79 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $11.22 | Facility | 55 · Aftercare only | $11.22 | $11.22 | $11.22 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.41 Typical High $7.41 | Facility | 56 · Pre-op care only | $7.41 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | 52 · Reduced service | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | 53 · Discontinued | $14.79 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | 55 · Aftercare only | $11.22 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | 56 · Pre-op care only | $7.41 | $7.41 | $7.41 |
Where Minnesota sits
The same service costs 2.1 times more in Wisconsin 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
$97.72
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.