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 $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
BCBS Setting Facility Modifier None Typical Low $478.63 Median $537.03 Typical High $812.83 | Facility | None | $478.63 | $537.03 | $812.83 |
BCBS Setting Professional Modifier None Typical Low $436.52 Median $537.03 Typical High $537.03 | Professional | None | $436.52 | $537.03 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $1,819.70 Typical High $4,570.88 | Facility | None | $346.74 | $1,819.70 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $660.69 Typical High $776.25 | Professional | None | $616.60 | $660.69 | $776.25 |
Health Partners Setting Facility Modifier None Typical Low $1,148.15 Median $1,862.09 Typical High $4,365.16 | Facility | None | $1,148.15 | $1,862.09 | $4,365.16 |
Health Partners Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
Medica Setting Facility Modifier None Typical Low $281.84 Median $537.03 Typical High $2,570.40 | Facility | None | $281.84 | $537.03 | $2,570.40 |
Medica Setting Professional Modifier None Typical Low $208.93 Median $380.19 Typical High $3,311.31 | Professional | None | $208.93 | $380.19 | $3,311.31 |
United Setting Facility Modifier None Typical Low $173.78 Median $251.19 Typical High $676.08 | Facility | None | $173.78 | $251.19 | $676.08 |
United Setting Professional Modifier None Typical Low $177.83 Median $295.12 Typical High $512.86 | Professional | None | $177.83 | $295.12 | $512.86 |
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 $223.87 Median $223.87 Typical High $223.87 | Facility | 52 · Reduced service | $223.87 | $223.87 | $223.87 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | 53 · Discontinued | $89.13 | $89.13 | $89.13 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | 55 · Aftercare only | $67.61 | $67.61 | $67.61 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $44.67 | Facility | 56 · Pre-op care only | $44.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $223.87 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $44.67 | $44.67 | $44.67 |
Where Minnesota sits
The same service costs 2.9 times more in Iowa than in Kansas. 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· 9th of 51
$490
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.