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 $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $74.13 Typical High $74.13 | Professional | None | $72.44 | $74.13 | $74.13 |
BCBS Minnesota Setting Facility Modifier None Typical Low $79.43 Median $87.10 Typical High $134.90 | Facility | None | $79.43 | $87.10 | $134.90 |
BCBS Minnesota Setting Professional Modifier None Typical Low $72.44 Median $89.13 Typical High $89.13 | Professional | None | $72.44 | $89.13 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $302.00 Typical High $758.58 | Facility | None | $69.18 | $302.00 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $107.15 Typical High $128.82 | Professional | None | $102.33 | $107.15 | $128.82 |
Health Partners Setting Facility Modifier None Typical Low $190.55 Median $302.00 Typical High $707.95 | Facility | None | $190.55 | $302.00 | $707.95 |
Health Partners Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
Medica Setting Facility Modifier None Typical Low $38.02 Median $89.13 Typical High $407.38 | Facility | None | $38.02 | $89.13 | $407.38 |
Medica Setting Professional Modifier None Typical Low $34.67 Median $58.88 Typical High $446.68 | Professional | None | $34.67 | $58.88 | $446.68 |
United Setting Facility Modifier None Typical Low $91.20 Median $107.15 Typical High $128.82 | Facility | None | $91.20 | $107.15 | $128.82 |
United Setting Professional Modifier None Typical Low $29.51 Median $45.71 Typical High $79.43 | Professional | None | $29.51 | $45.71 | $79.43 |
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 $37.15 Median $37.15 Typical High $37.15 | Facility | 52 · Reduced service | $37.15 | $37.15 | $37.15 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $14.79 Median $14.79 Typical High $14.79 | Facility | 53 · Discontinued | $14.79 | $14.79 | $14.79 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $10.96 | Facility | 55 · Aftercare only | $10.96 | $10.96 | $10.96 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.41 Typical High $7.41 | Facility | 56 · Pre-op care only | $7.41 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $36.31 Median $37.15 Typical High $37.15 | Professional | 52 · Reduced service | $36.31 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $14.79 Typical High $14.79 | Professional | 53 · Discontinued | $14.45 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $10.96 Typical High $10.96 | Professional | 55 · Aftercare only | $10.72 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.41 Typical High $7.41 | Professional | 56 · Pre-op care only | $7.24 | $7.41 | $7.41 |
Where Minnesota sits
The same service costs 2.0 times more in Montana than in South Carolina. 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· 3rd of 51
$87.10
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.