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 $562.34 Median $562.34 Typical High $562.34 | Facility | None | $562.34 | $562.34 | $562.34 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $562.34 Typical High $562.34 | Professional | None | $549.54 | $562.34 | $562.34 |
BCBS Minnesota Setting Facility Modifier None Typical Low $676.08 Median $812.83 Typical High $1,230.27 | Facility | None | $676.08 | $812.83 | $1,230.27 |
BCBS Minnesota Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $676.08 | Professional | None | $549.54 | $676.08 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $2,290.87 Typical High $5,754.40 | Facility | None | $371.54 | $2,290.87 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $812.83 Typical High $977.24 | Professional | None | $776.25 | $812.83 | $977.24 |
Health Partners Setting Facility Modifier None Typical Low $1,445.44 Median $2,290.87 Typical High $5,495.41 | Facility | None | $1,445.44 | $2,290.87 | $5,495.41 |
Health Partners Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | None | $776.25 | $776.25 | $776.25 |
Medica Setting Facility Modifier None Typical Low $199.53 Median $660.69 Typical High $2,884.03 | Facility | None | $199.53 | $660.69 | $2,884.03 |
Medica Setting Professional Modifier None Typical Low $269.15 Median $457.09 Typical High $3,311.31 | Professional | None | $269.15 | $457.09 | $3,311.31 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
United Setting Professional Modifier None Typical Low $223.87 Median $354.81 Typical High $602.56 | Professional | None | $223.87 | $354.81 | $602.56 |
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 $281.84 Median $281.84 Typical High $281.84 | Facility | 52 · Reduced service | $281.84 | $281.84 | $281.84 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | 53 · Discontinued | $112.20 | $112.20 | $112.20 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | 55 · Aftercare only | $85.11 | $85.11 | $85.11 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | 56 · Pre-op care only | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $269.15 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $269.15 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $109.65 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $85.11 Typical High $85.11 | Professional | 55 · Aftercare only | $81.28 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $54.95 | $56.23 | $56.23 |
Where Minnesota sits
The same service costs 2.6 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
$631
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.