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 $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $275.42 Typical High $275.42 | Professional | None | $239.88 | $275.42 | $275.42 |
BCBS Minnesota Setting Facility Modifier None Typical Low $295.12 Median $323.59 Typical High $501.19 | Facility | None | $295.12 | $323.59 | $501.19 |
BCBS Minnesota Setting Professional Modifier None Typical Low $263.03 Median $331.13 Typical High $331.13 | Professional | None | $263.03 | $331.13 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $1,096.48 Typical High $2,818.38 | Facility | None | $165.96 | $1,096.48 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $398.11 Typical High $478.63 | Professional | None | $380.19 | $398.11 | $478.63 |
Health Partners Setting Facility Modifier None Typical Low $707.95 Median $1,122.02 Typical High $2,630.27 | Facility | None | $707.95 | $1,122.02 | $2,630.27 |
Health Partners Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
Medica Setting Facility Modifier None Typical Low $114.82 Median $323.59 Typical High $1,380.38 | Facility | None | $114.82 | $323.59 | $1,380.38 |
Medica Setting Professional Modifier None Typical Low $128.82 Median $199.53 Typical High $1,778.28 | Professional | None | $128.82 | $199.53 | $1,778.28 |
United Setting Facility Modifier None Typical Low $134.90 Median $141.25 Typical High $363.08 | Facility | None | $134.90 | $141.25 | $363.08 |
United Setting Professional Modifier None Typical Low $104.71 Median $162.18 Typical High $281.84 | Professional | None | $104.71 | $162.18 | $281.84 |
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 $138.04 Median $138.04 Typical High $138.04 | Facility | 52 · Reduced service | $138.04 | $138.04 | $138.04 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | 53 · Discontinued | $54.95 | $54.95 | $54.95 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $40.74 | Facility | 55 · Aftercare only | $40.74 | $40.74 | $40.74 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $27.54 Median $27.54 Typical High $27.54 | Facility | 56 · Pre-op care only | $27.54 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $120.23 Median $138.04 Typical High $138.04 | Professional | 52 · Reduced service | $120.23 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $54.95 Typical High $54.95 | Professional | 53 · Discontinued | $47.86 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $35.48 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $27.54 Typical High $27.54 | Professional | 56 · Pre-op care only | $23.99 | $27.54 | $27.54 |
Where Minnesota sits
The same service costs 2.8 times more in Montana 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
$316
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.