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 $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $457.09 Typical High $457.09 | Professional | None | $389.05 | $457.09 | $457.09 |
BCBS Minnesota Setting Facility Modifier None Typical Low $549.54 Median $660.69 Typical High $1,000.00 | Facility | None | $549.54 | $660.69 | $1,000.00 |
BCBS Minnesota Setting Professional Modifier None Typical Low $436.52 Median $549.54 Typical High $549.54 | Professional | None | $436.52 | $549.54 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $1,862.09 Typical High $4,677.35 | Facility | None | $251.19 | $1,862.09 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $660.69 Typical High $794.33 | Professional | None | $630.96 | $660.69 | $794.33 |
Health Partners Setting Facility Modifier None Typical Low $1,174.90 Median $1,862.09 Typical High $4,365.16 | Facility | None | $1,174.90 | $1,862.09 | $4,365.16 |
Health Partners Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
Medica Setting Facility Modifier None Typical Low $173.78 Median $537.03 Typical High $2,089.30 | Facility | None | $173.78 | $537.03 | $2,089.30 |
Medica Setting Professional Modifier None Typical Low $199.53 Median $302.00 Typical High $2,630.27 | Professional | None | $199.53 | $302.00 | $2,630.27 |
United Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
United Setting Professional Modifier None Typical Low $158.49 Median $269.15 Typical High $446.68 | Professional | None | $158.49 | $269.15 | $446.68 |
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 $223.87 Median $223.87 Typical High $223.87 | Facility | 52 · Reduced service | $223.87 | $223.87 | $223.87 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | 53 · Discontinued | $91.20 | $91.20 | $91.20 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | 55 · Aftercare only | $67.61 | $67.61 | $67.61 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $45.71 | Facility | 56 · Pre-op care only | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $194.98 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $194.98 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $91.20 Typical High $91.20 | Professional | 53 · Discontinued | $77.62 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $57.54 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $45.71 Typical High $45.71 | Professional | 56 · Pre-op care only | $38.90 | $45.71 | $45.71 |
Where Minnesota sits
The same service costs 3.4 times more in Montana than in New York. 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· 5th of 51
$490
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.