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 $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
BCBS Minnesota Setting Facility Modifier None Typical Low $380.19 Median $457.09 Typical High $691.83 | Facility | None | $380.19 | $457.09 | $691.83 |
BCBS Minnesota Setting Professional Modifier None Typical Low $309.03 Median $380.19 Typical High $380.19 | Professional | None | $309.03 | $380.19 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $1,288.25 Typical High $3,235.94 | Facility | None | $302.00 | $1,288.25 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $457.09 Typical High $549.54 | Professional | None | $436.52 | $457.09 | $549.54 |
Health Partners Setting Facility Modifier None Typical Low $812.83 Median $1,288.25 Typical High $3,090.30 | Facility | None | $812.83 | $1,288.25 | $3,090.30 |
Health Partners Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
Medica Setting Facility Modifier None Typical Low $151.36 Median $371.54 Typical High $1,621.81 | Facility | None | $151.36 | $371.54 | $1,621.81 |
Medica Setting Professional Modifier None Typical Low $144.54 Median $257.04 Typical High $1,995.26 | Professional | None | $144.54 | $257.04 | $1,995.26 |
United Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
United Setting Professional Modifier None Typical Low $125.89 Median $199.53 Typical High $346.74 | Professional | None | $125.89 | $199.53 | $346.74 |
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 $158.49 Median $158.49 Typical High $158.49 | Facility | 52 · Reduced service | $158.49 | $158.49 | $158.49 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | 53 · Discontinued | $63.10 | $63.10 | $63.10 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $47.86 Median $47.86 Typical High $47.86 | Facility | 55 · Aftercare only | $47.86 | $47.86 | $47.86 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $31.62 Median $31.62 Typical High $31.62 | Facility | 56 · Pre-op care only | $31.62 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | 55 · Aftercare only | $47.86 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $31.62 | $31.62 | $31.62 |
Where Minnesota sits
The same service costs 3.0 times more in Iowa 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
$363
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.