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 $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $125.89 Typical High $125.89 | Professional | None | $123.03 | $125.89 | $125.89 |
BCBS Setting Facility Modifier None Typical Low $138.04 Median $151.36 Typical High $229.09 | Facility | None | $138.04 | $151.36 | $229.09 |
BCBS Setting Professional Modifier None Typical Low $123.03 Median $154.88 Typical High $154.88 | Professional | None | $123.03 | $154.88 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $524.81 Typical High $1,318.26 | Facility | None | $97.72 | $524.81 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $186.21 Typical High $223.87 | Professional | None | $173.78 | $186.21 | $223.87 |
Health Partners Setting Facility Modifier None Typical Low $331.13 Median $524.81 Typical High $1,230.27 | Facility | None | $331.13 | $524.81 | $1,230.27 |
Health Partners Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
Medica Setting Facility Modifier None Typical Low $44.67 Median $151.36 Typical High $707.95 | Facility | None | $44.67 | $151.36 | $707.95 |
Medica Setting Professional Modifier None Typical Low $60.26 Median $102.33 Typical High $758.58 | Professional | None | $60.26 | $102.33 | $758.58 |
United Setting Facility Modifier None Typical Low $154.88 Median $181.97 Typical High $218.78 | Facility | None | $154.88 | $181.97 | $218.78 |
United Setting Professional Modifier None Typical Low $50.12 Median $79.43 Typical High $138.04 | Professional | None | $50.12 | $79.43 | $138.04 |
4 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 55 · Aftercare only Typical Low $19.05 Median $19.05 Typical High $19.05 | Facility | 55 · Aftercare only | $19.05 | $19.05 | $19.05 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $12.59 | Facility | 56 · Pre-op care only | $12.59 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $19.05 Typical High $19.05 | Professional | 55 · Aftercare only | $18.62 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $12.30 | $12.59 | $12.59 |
Where Minnesota sits
The same service costs 4.2 times more in Kansas 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· 4th of 51
$151
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.