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 $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
BCBS Minnesota Setting Facility Modifier None Typical Low $109.65 Median $123.03 Typical High $186.21 | Facility | None | $109.65 | $123.03 | $186.21 |
BCBS Minnesota Setting Professional Modifier None Typical Low $100.00 Median $125.89 Typical High $125.89 | Professional | None | $100.00 | $125.89 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $416.87 Typical High $1,047.13 | Facility | None | $74.13 | $416.87 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $151.36 Typical High $181.97 | Professional | None | $141.25 | $151.36 | $181.97 |
Health Partners Setting Facility Modifier None Typical Low $269.15 Median $426.58 Typical High $1,000.00 | Facility | None | $269.15 | $426.58 | $1,000.00 |
Health Partners Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
Medica Setting Facility Modifier None Typical Low $70.79 Median $128.82 Typical High $616.60 | Facility | None | $70.79 | $128.82 | $616.60 |
Medica Setting Professional Modifier None Typical Low $48.98 Median $64.57 Typical High $776.25 | Professional | None | $48.98 | $64.57 | $776.25 |
United Setting Facility Modifier None Typical Low $77.62 Median $79.43 Typical High $158.49 | Facility | None | $77.62 | $79.43 | $158.49 |
United Setting Professional Modifier None Typical Low $40.74 Median $64.57 Typical High $125.89 | Professional | None | $40.74 | $64.57 | $125.89 |
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 $42.66 Median $42.66 Typical High $42.66 | Facility | 52 · Reduced service | $42.66 | $42.66 | $42.66 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $16.98 | Facility | 53 · Discontinued | $16.98 | $16.98 | $16.98 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.88 Median $12.88 Typical High $12.88 | Facility | 55 · Aftercare only | $12.88 | $12.88 | $12.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $8.51 | Facility | 56 · Pre-op care only | $8.51 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | 52 · Reduced service | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | 53 · Discontinued | $16.98 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | 55 · Aftercare only | $12.88 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | 56 · Pre-op care only | $8.51 | $8.51 | $8.51 |
Where Minnesota sits
The same service costs 3.1 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· 7th of 51
$120
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.