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 $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $75.86 Typical High $91.20 | Professional | None | $74.13 | $75.86 | $91.20 |
BCBS Minnesota Setting Facility Modifier None Typical Low $81.28 Median $91.20 Typical High $138.04 | Facility | None | $81.28 | $91.20 | $138.04 |
BCBS Minnesota Setting Professional Modifier None Typical Low $74.13 Median $93.33 Typical High $93.33 | Professional | None | $74.13 | $93.33 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $309.03 Typical High $794.33 | Facility | None | $50.12 | $309.03 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $112.20 Typical High $134.90 | Professional | None | $104.71 | $112.20 | $134.90 |
Health Partners Setting Facility Modifier None Typical Low $199.53 Median $316.23 Typical High $741.31 | Facility | None | $199.53 | $316.23 | $741.31 |
Health Partners Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Medica Setting Facility Modifier None Typical Low $38.90 Median $91.20 Typical High $426.58 | Facility | None | $38.90 | $91.20 | $426.58 |
Medica Setting Professional Modifier None Typical Low $36.31 Median $60.26 Typical High $457.09 | Professional | None | $36.31 | $60.26 | $457.09 |
United Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $109.65 | Facility | None | $44.67 | $44.67 | $109.65 |
United Setting Professional Modifier None Typical Low $30.20 Median $47.86 Typical High $81.28 | Professional | None | $30.20 | $47.86 | $81.28 |
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 $38.02 Median $38.02 Typical High $38.02 | Facility | 52 · Reduced service | $38.02 | $38.02 | $38.02 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $15.14 | Facility | 53 · Discontinued | $15.14 | $15.14 | $15.14 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $11.48 | Facility | 55 · Aftercare only | $11.48 | $11.48 | $11.48 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $7.59 | Facility | 56 · Pre-op care only | $7.59 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $38.02 Typical High $38.02 | Professional | 52 · Reduced service | $37.15 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $15.14 Typical High $15.14 | Professional | 53 · Discontinued | $14.79 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.48 Typical High $11.48 | Professional | 55 · Aftercare only | $11.22 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.59 Typical High $7.59 | Professional | 56 · Pre-op care only | $7.41 | $7.59 | $7.59 |
Where Minnesota sits
The same service costs 2.8 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· 6th of 51
$91.20
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.