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 $23.99 Median $23.99 Typical High $23.99 | Facility | None | $23.99 | $23.99 | $23.99 |
Aetna Setting Professional Modifier None Typical Low $22.91 Median $23.99 Typical High $23.99 | Professional | None | $22.91 | $23.99 | $23.99 |
BCBS Minnesota Setting Facility Modifier None Typical Low $25.70 Median $28.84 Typical High $43.65 | Facility | None | $25.70 | $28.84 | $43.65 |
BCBS Minnesota Setting Professional Modifier None Typical Low $23.44 Median $28.84 Typical High $28.84 | Professional | None | $23.44 | $28.84 | $28.84 |
Cigna Setting Facility Modifier None Typical Low $18.62 Median $95.50 Typical High $245.47 | Facility | None | $18.62 | $95.50 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $34.67 Typical High $41.69 | Professional | None | $33.11 | $34.67 | $41.69 |
Health Partners Setting Facility Modifier None Typical Low $61.66 Median $97.72 Typical High $234.42 | Facility | None | $61.66 | $97.72 | $234.42 |
Health Partners Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Medica Setting Facility Modifier None Typical Low $11.75 Median $28.84 Typical High $141.25 | Facility | None | $11.75 | $28.84 | $141.25 |
Medica Setting Professional Modifier None Typical Low $11.48 Median $19.95 Typical High $162.18 | Professional | None | $11.48 | $19.95 | $162.18 |
United Setting Facility Modifier None Typical Low $14.45 Median $16.60 Typical High $36.31 | Facility | None | $14.45 | $16.60 | $36.31 |
United Setting Professional Modifier None Typical Low $9.55 Median $15.49 Typical High $26.92 | Professional | None | $9.55 | $15.49 | $26.92 |
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 $12.02 Median $12.02 Typical High $12.02 | Facility | 52 · Reduced service | $12.02 | $12.02 | $12.02 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $4.79 Median $4.79 Typical High $4.79 | Facility | 53 · Discontinued | $4.79 | $4.79 | $4.79 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.63 Median $3.63 Typical High $3.63 | Facility | 55 · Aftercare only | $3.63 | $3.63 | $3.63 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.40 Median $2.40 Typical High $2.40 | Facility | 56 · Pre-op care only | $2.40 | $2.40 | $2.40 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $11.48 Median $12.02 Typical High $12.02 | Professional | 52 · Reduced service | $11.48 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.57 Median $4.79 Typical High $4.79 | Professional | 53 · Discontinued | $4.57 | $4.79 | $4.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.47 Median $3.63 Typical High $3.63 | Professional | 55 · Aftercare only | $3.47 | $3.63 | $3.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.29 Median $2.40 Typical High $2.40 | Professional | 56 · Pre-op care only | $2.29 | $2.40 | $2.40 |
Where Minnesota sits
The same service costs 2.8 times more in Hawaii than in Pennsylvania. 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· 9th of 51
$28.84
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.