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 $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
BCBS Minnesota Setting Facility Modifier None Typical Low $223.87 Median $245.47 Typical High $380.19 | Facility | None | $223.87 | $245.47 | $380.19 |
BCBS Minnesota Setting Professional Modifier None Typical Low $199.53 Median $251.19 Typical High $251.19 | Professional | None | $199.53 | $251.19 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $831.76 Typical High $2,137.96 | Facility | None | $158.49 | $831.76 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $302.00 Typical High $363.08 | Professional | None | $288.40 | $302.00 | $363.08 |
Health Partners Setting Facility Modifier None Typical Low $537.03 Median $851.14 Typical High $1,995.26 | Facility | None | $537.03 | $851.14 | $1,995.26 |
Health Partners Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
Medica Setting Facility Modifier None Typical Low $128.82 Median $245.47 Typical High $1,148.15 | Facility | None | $128.82 | $245.47 | $1,148.15 |
Medica Setting Professional Modifier None Typical Low $97.72 Median $169.82 Typical High $1,479.11 | Professional | None | $97.72 | $169.82 | $1,479.11 |
United Setting Facility Modifier None Typical Low $107.15 Median $131.83 Typical High $302.00 | Facility | None | $107.15 | $131.83 | $302.00 |
United Setting Professional Modifier None Typical Low $81.28 Median $131.83 Typical High $229.09 | Professional | None | $81.28 | $131.83 | $229.09 |
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 $102.33 Median $102.33 Typical High $102.33 | Facility | 52 · Reduced service | $102.33 | $102.33 | $102.33 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $41.69 | Facility | 53 · Discontinued | $41.69 | $41.69 | $41.69 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $30.90 | Facility | 55 · Aftercare only | $30.90 | $30.90 | $30.90 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $20.89 | Facility | 56 · Pre-op care only | $20.89 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 52 · Reduced service | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | 53 · Discontinued | $41.69 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $20.89 |
Where Minnesota sits
The same service costs 2.4 times more in Hawaii than in New Jersey. 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· 10th of 51
$245
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.