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 $20.89 Median $20.89 Typical High $20.89 | Facility | None | $20.89 | $20.89 | $20.89 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $25.12 | Professional | None | $20.89 | $20.89 | $25.12 |
BCBS Minnesota Setting Facility Modifier None Typical Low $22.39 Median $25.12 Typical High $38.02 | Facility | None | $22.39 | $25.12 | $38.02 |
BCBS Minnesota Setting Professional Modifier None Typical Low $20.42 Median $25.12 Typical High $25.12 | Professional | None | $20.42 | $25.12 | $25.12 |
Cigna Setting Facility Modifier None Typical Low $16.60 Median $85.11 Typical High $213.80 | Facility | None | $16.60 | $85.11 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $30.90 Typical High $36.31 | Professional | None | $28.84 | $30.90 | $36.31 |
Health Partners Setting Facility Modifier None Typical Low $53.70 Median $87.10 Typical High $204.17 | Facility | None | $53.70 | $87.10 | $204.17 |
Health Partners Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Medica Setting Facility Modifier None Typical Low $11.75 Median $25.12 Typical High $131.83 | Facility | None | $11.75 | $25.12 | $131.83 |
Medica Setting Professional Modifier None Typical Low $10.00 Median $18.62 Typical High $158.49 | Professional | None | $10.00 | $18.62 | $158.49 |
United Setting Facility Modifier None Typical Low $12.88 Median $16.22 Typical High $33.88 | Facility | None | $12.88 | $16.22 | $33.88 |
United Setting Professional Modifier None Typical Low $8.32 Median $14.13 Typical High $25.12 | Professional | None | $8.32 | $14.13 | $25.12 |
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 $10.47 Median $10.47 Typical High $10.47 | Facility | 52 · Reduced service | $10.47 | $10.47 | $10.47 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $4.17 Median $4.17 Typical High $4.17 | Facility | 53 · Discontinued | $4.17 | $4.17 | $4.17 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.16 Median $3.16 Typical High $3.16 | Facility | 55 · Aftercare only | $3.16 | $3.16 | $3.16 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.09 Typical High $2.09 | Facility | 56 · Pre-op care only | $2.09 | $2.09 | $2.09 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | 52 · Reduced service | $10.47 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.17 Typical High $4.17 | Professional | 53 · Discontinued | $4.17 | $4.17 | $4.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | 55 · Aftercare only | $3.16 | $3.16 | $3.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.09 Typical High $2.09 | Professional | 56 · Pre-op care only | $2.09 | $2.09 | $2.09 |
Where Minnesota sits
The same service costs 3.0 times more in Hawaii 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· 14th of 51
$25.12
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.