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 $812.83 Median $812.83 Typical High $812.83 | Facility | None | $812.83 | $812.83 | $812.83 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $812.83 Typical High $812.83 | Professional | None | $776.25 | $812.83 | $812.83 |
BCBS Setting Facility Modifier None Typical Low $891.25 Median $977.24 Typical High $1,479.11 | Facility | None | $891.25 | $977.24 | $1,479.11 |
BCBS Setting Professional Modifier None Typical Low $794.33 Median $1,000.00 Typical High $1,000.00 | Professional | None | $794.33 | $1,000.00 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $3,311.31 Typical High $8,511.38 | Facility | None | $645.65 | $3,311.31 | $8,511.38 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,202.26 Typical High $1,445.44 | Professional | None | $1,122.02 | $1,202.26 | $1,445.44 |
Health Partners Setting Facility Modifier None Typical Low $2,137.96 Median $3,388.44 Typical High $7,943.28 | Facility | None | $2,137.96 | $3,388.44 | $7,943.28 |
Health Partners Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,122.02 | $1,122.02 | $1,122.02 |
Medica Setting Facility Modifier None Typical Low $323.59 Median $977.24 Typical High $4,073.80 | Facility | None | $323.59 | $977.24 | $4,073.80 |
Medica Setting Professional Modifier None Typical Low $323.59 Median $562.34 Typical High $4,677.35 | Professional | None | $323.59 | $562.34 | $4,677.35 |
United Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $1,023.29 | Facility | None | $489.78 | $489.78 | $1,023.29 |
United Setting Professional Modifier None Typical Low $295.12 Median $489.78 Typical High $812.83 | Professional | None | $295.12 | $489.78 | $812.83 |
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 $407.38 Median $407.38 Typical High $407.38 | Facility | 52 · Reduced service | $407.38 | $407.38 | $407.38 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | 53 · Discontinued | $165.96 | $165.96 | $165.96 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | 55 · Aftercare only | $123.03 | $123.03 | $123.03 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | 56 · Pre-op care only | $81.28 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $389.05 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $389.05 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $154.88 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $117.49 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $77.62 | $81.28 | $81.28 |
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
$955
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.