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 $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $457.09 Typical High $457.09 | Professional | None | $407.38 | $457.09 | $457.09 |
BCBS Minnesota Setting Facility Modifier None Typical Low $489.78 Median $549.54 Typical High $831.76 | Facility | None | $489.78 | $549.54 | $831.76 |
BCBS Minnesota Setting Professional Modifier None Typical Low $446.68 Median $562.34 Typical High $562.34 | Professional | None | $446.68 | $562.34 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $1,862.09 Typical High $4,786.30 | Facility | None | $363.08 | $1,862.09 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $676.08 Typical High $812.83 | Professional | None | $630.96 | $676.08 | $812.83 |
Health Partners Setting Facility Modifier None Typical Low $1,202.26 Median $1,905.46 Typical High $4,466.84 | Facility | None | $1,202.26 | $1,905.46 | $4,466.84 |
Health Partners Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
Medica Setting Facility Modifier None Typical Low $186.21 Median $549.54 Typical High $2,344.23 | Facility | None | $186.21 | $549.54 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $199.53 Median $331.13 Typical High $2,884.03 | Professional | None | $199.53 | $331.13 | $2,884.03 |
United Setting Facility Modifier None Typical Low $165.96 Median $223.87 Typical High $588.84 | Facility | None | $165.96 | $223.87 | $588.84 |
United Setting Professional Modifier None Typical Low $169.82 Median $275.42 Typical High $467.74 | Professional | None | $169.82 | $275.42 | $467.74 |
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 $229.09 Median $229.09 Typical High $229.09 | Facility | 52 · Reduced service | $229.09 | $229.09 | $229.09 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | 53 · Discontinued | $91.20 | $91.20 | $91.20 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | 55 · Aftercare only | $69.18 | $69.18 | $69.18 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $45.71 | Facility | 56 · Pre-op care only | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $229.09 Typical High $229.09 | Professional | 52 · Reduced service | $204.17 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $91.20 Typical High $91.20 | Professional | 53 · Discontinued | $81.28 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $61.66 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $45.71 Typical High $45.71 | Professional | 56 · Pre-op care only | $40.74 | $45.71 | $45.71 |
Where Minnesota sits
The same service costs 2.2 times more in Wisconsin than in Pennsylvania. 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
$537
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.