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 $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $467.74 Typical High $467.74 | Professional | None | $436.52 | $467.74 | $467.74 |
BCBS Setting Facility Modifier None Typical Low $501.19 Median $562.34 Typical High $851.14 | Facility | None | $501.19 | $562.34 | $851.14 |
BCBS Setting Professional Modifier None Typical Low $457.09 Median $575.44 Typical High $575.44 | Professional | None | $457.09 | $575.44 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $1,905.46 Typical High $4,897.79 | Facility | None | $363.08 | $1,905.46 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $691.83 Typical High $831.76 | Professional | None | $645.65 | $691.83 | $831.76 |
Health Partners Setting Facility Modifier None Typical Low $1,230.27 Median $1,949.84 Typical High $4,570.88 | Facility | None | $1,230.27 | $1,949.84 | $4,570.88 |
Health Partners Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
Medica Setting Facility Modifier None Typical Low $239.88 Median $562.34 Typical High $2,630.27 | Facility | None | $239.88 | $562.34 | $2,630.27 |
Medica Setting Professional Modifier None Typical Low $223.87 Median $371.54 Typical High $2,818.38 | Professional | None | $223.87 | $371.54 | $2,818.38 |
United Setting Facility Modifier None Typical Low $575.44 Median $676.08 Typical High $812.83 | Facility | None | $575.44 | $676.08 | $812.83 |
United Setting Professional Modifier None Typical Low $186.21 Median $295.12 Typical High $501.19 | Professional | None | $186.21 | $295.12 | $501.19 |
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 $234.42 Median $234.42 Typical High $234.42 | Facility | 52 · Reduced service | $234.42 | $234.42 | $234.42 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | 53 · Discontinued | $93.33 | $93.33 | $93.33 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | 55 · Aftercare only | $70.79 | $70.79 | $70.79 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $46.77 | Facility | 56 · Pre-op care only | $46.77 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $229.09 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $229.09 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $91.20 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $70.79 Typical High $70.79 | Professional | 55 · Aftercare only | $69.18 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $45.71 | $46.77 | $46.77 |
Where Minnesota sits
The same service costs 2.2 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· 2nd of 51
$562
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.