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 $26.30 Median $26.30 Typical High $26.30 | Facility | None | $26.30 | $26.30 | $26.30 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $26.30 Typical High $26.30 | Professional | None | $25.70 | $26.30 | $26.30 |
BCBS Minnesota Setting Facility Modifier None Typical Low $34.67 Median $74.13 Typical High $245.47 | Facility | None | $34.67 | $74.13 | $245.47 |
BCBS Minnesota Setting Professional Modifier None Typical Low $199.53 Median $251.19 Typical High $251.19 | Professional | None | $199.53 | $251.19 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $25.12 Median $109.65 Typical High $275.42 | Facility | None | $25.12 | $109.65 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $38.90 Typical High $46.77 | Professional | None | $37.15 | $38.90 | $46.77 |
Health Partners Setting Facility Modifier None Typical Low $69.18 Median $109.65 Typical High $257.04 | Facility | None | $69.18 | $109.65 | $257.04 |
Health Partners Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
Medica Setting Facility Modifier None Typical Low $13.80 Median $32.36 Typical High $134.90 | Facility | None | $13.80 | $32.36 | $134.90 |
Medica Setting Professional Modifier None Typical Low $12.59 Median $21.38 Typical High $158.49 | Professional | None | $12.59 | $21.38 | $158.49 |
United Setting Facility Modifier None Typical Low $32.36 Median $38.90 Typical High $45.71 | Facility | None | $32.36 | $38.90 | $45.71 |
United Setting Professional Modifier None Typical Low $10.47 Median $16.60 Typical High $28.84 | Professional | None | $10.47 | $16.60 | $28.84 |
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 $13.18 Median $13.18 Typical High $13.18 | Facility | 52 · Reduced service | $13.18 | $13.18 | $13.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $5.37 Median $5.37 Typical High $5.37 | Facility | 53 · Discontinued | $5.37 | $5.37 | $5.37 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.98 Median $3.98 Typical High $3.98 | Facility | 55 · Aftercare only | $3.98 | $3.98 | $3.98 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.63 Median $2.63 Typical High $2.63 | Facility | 56 · Pre-op care only | $2.63 | $2.63 | $2.63 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.88 Median $13.18 Typical High $13.18 | Professional | 52 · Reduced service | $12.88 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $5.37 Typical High $5.37 | Professional | 53 · Discontinued | $5.25 | $5.37 | $5.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $3.98 Typical High $3.98 | Professional | 55 · Aftercare only | $3.89 | $3.98 | $3.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $2.63 Typical High $2.63 | Professional | 56 · Pre-op care only | $2.57 | $2.63 | $2.63 |
Where Minnesota sits
The same service costs 2.1 times more in Minnesota than in Washington, DC. 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· 1st of 51
$37.15
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.