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 $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $42.66 Typical High $51.29 | Professional | None | $33.11 | $42.66 | $51.29 |
BCBS Minnesota Setting Facility Modifier None Typical Low $45.71 Median $51.29 Typical High $77.62 | Facility | None | $45.71 | $51.29 | $77.62 |
BCBS Minnesota Setting Professional Modifier None Typical Low $41.69 Median $52.48 Typical High $52.48 | Professional | None | $41.69 | $52.48 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $173.78 Typical High $446.68 | Facility | None | $34.67 | $173.78 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $63.10 Typical High $75.86 | Professional | None | $58.88 | $63.10 | $75.86 |
Health Partners Setting Facility Modifier None Typical Low $112.20 Median $177.83 Typical High $416.87 | Facility | None | $112.20 | $177.83 | $416.87 |
Health Partners Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
Medica Setting Facility Modifier None Typical Low $19.50 Median $51.29 Typical High $229.09 | Facility | None | $19.50 | $51.29 | $229.09 |
Medica Setting Professional Modifier None Typical Low $20.42 Median $33.11 Typical High $93.33 | Professional | None | $20.42 | $33.11 | $93.33 |
United Setting Facility Modifier None Typical Low $16.22 Median $29.51 Typical High $60.26 | Facility | None | $16.22 | $29.51 | $60.26 |
United Setting Professional Modifier None Typical Low $16.98 Median $25.70 Typical High $44.67 | Professional | None | $16.98 | $25.70 | $44.67 |
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 $21.38 Median $21.38 Typical High $21.38 | Facility | 52 · Reduced service | $21.38 | $21.38 | $21.38 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $8.51 Median $8.51 Typical High $8.51 | Facility | 53 · Discontinued | $8.51 | $8.51 | $8.51 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $6.46 | Facility | 55 · Aftercare only | $6.46 | $6.46 | $6.46 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $4.27 | Facility | 56 · Pre-op care only | $4.27 | $4.27 | $4.27 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $19.05 Median $21.38 Typical High $21.38 | Professional | 52 · Reduced service | $19.05 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $8.51 Typical High $8.51 | Professional | 53 · Discontinued | $7.59 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $6.46 Typical High $6.46 | Professional | 55 · Aftercare only | $5.62 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $4.27 Typical High $4.27 | Professional | 56 · Pre-op care only | $3.80 | $4.27 | $4.27 |
Where Minnesota sits
The same service costs 3.2 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· 5th of 51
$48.98
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.