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 $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $141.25 Typical High $144.54 | Professional | None | $120.23 | $141.25 | $144.54 |
BCBS Minnesota Setting Facility Modifier None Typical Low $181.97 Median $204.17 Typical High $309.03 | Facility | None | $181.97 | $204.17 | $309.03 |
BCBS Minnesota Setting Professional Modifier None Typical Low $165.96 Median $204.17 Typical High $204.17 | Professional | None | $165.96 | $204.17 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $691.83 Typical High $1,737.80 | Facility | None | $125.89 | $691.83 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $251.19 Typical High $295.12 | Professional | None | $234.42 | $251.19 | $295.12 |
Health Partners Setting Facility Modifier None Typical Low $436.52 Median $691.83 Typical High $1,659.59 | Facility | None | $436.52 | $691.83 | $1,659.59 |
Health Partners Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
Medica Setting Facility Modifier None Typical Low $134.90 Median $204.17 Typical High $933.25 | Facility | None | $134.90 | $204.17 | $933.25 |
Medica Setting Professional Modifier None Typical Low $81.28 Median $100.00 Typical High $389.05 | Professional | None | $81.28 | $100.00 | $389.05 |
United Setting Facility Modifier None Typical Low $208.93 Median $245.47 Typical High $295.12 | Facility | None | $208.93 | $245.47 | $295.12 |
United Setting Professional Modifier None Typical Low $67.61 Median $100.00 Typical High $194.98 | Professional | None | $67.61 | $100.00 | $194.98 |
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 $70.79 Median $70.79 Typical High $70.79 | Facility | 52 · Reduced service | $70.79 | $70.79 | $70.79 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $28.18 Median $28.18 Typical High $28.18 | Facility | 53 · Discontinued | $28.18 | $28.18 | $28.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $21.38 Median $21.38 Typical High $21.38 | Facility | 55 · Aftercare only | $21.38 | $21.38 | $21.38 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.13 Typical High $14.13 | Facility | 56 · Pre-op care only | $14.13 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $70.79 Typical High $72.44 | Professional | 52 · Reduced service | $70.79 | $70.79 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $28.18 Typical High $29.51 | Professional | 53 · Discontinued | $28.18 | $28.18 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $21.38 Typical High $21.88 | Professional | 55 · Aftercare only | $21.38 | $21.38 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.13 Typical High $14.45 | Professional | 56 · Pre-op care only | $14.13 | $14.13 | $14.45 |
Where Minnesota sits
The same service costs 2.1 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· 2nd of 51
$195
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.