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 $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $204.17 Typical High $204.17 | Professional | None | $190.55 | $204.17 | $204.17 |
BCBS Minnesota Setting Facility Modifier None Typical Low $218.78 Median $239.88 Typical High $371.54 | Facility | None | $218.78 | $239.88 | $371.54 |
BCBS Minnesota Setting Professional Modifier None Typical Low $194.98 Median $245.47 Typical High $245.47 | Professional | None | $194.98 | $245.47 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $812.83 Typical High $2,089.30 | Facility | None | $169.82 | $812.83 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $295.12 Typical High $354.81 | Professional | None | $281.84 | $295.12 | $354.81 |
Health Partners Setting Facility Modifier None Typical Low $524.81 Median $831.76 Typical High $1,949.84 | Facility | None | $524.81 | $831.76 | $1,949.84 |
Health Partners Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
Medica Setting Facility Modifier None Typical Low $95.50 Median $239.88 Typical High $1,148.15 | Facility | None | $95.50 | $239.88 | $1,148.15 |
Medica Setting Professional Modifier None Typical Low $87.10 Median $154.88 Typical High $1,318.26 | Professional | None | $87.10 | $154.88 | $1,318.26 |
United Setting Facility Modifier None Typical Low $107.15 Median $134.90 Typical High $275.42 | Facility | None | $107.15 | $134.90 | $275.42 |
United Setting Professional Modifier None Typical Low $79.43 Median $120.23 Typical High $208.93 | Professional | None | $79.43 | $120.23 | $208.93 |
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 $40.74 Median $40.74 Typical High $40.74 | Facility | 53 · Discontinued | $40.74 | $40.74 | $40.74 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $30.20 | Facility | 55 · Aftercare only | $30.20 | $30.20 | $30.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $20.42 | Facility | 56 · Pre-op care only | $20.42 | $20.42 | $20.42 |
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 $40.74 Median $40.74 Typical High $40.74 | Professional | 53 · Discontinued | $40.74 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | 55 · Aftercare only | $30.20 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $20.42 |
Where Minnesota sits
The same service costs 2.7 times more in Hawaii than in Washington, DC. 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· 6th of 51
$234
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.