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 $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $102.33 Typical High $102.33 | Professional | None | $81.28 | $102.33 | $102.33 |
BCBS Minnesota Setting Facility Modifier None Typical Low $131.83 Median $144.54 Typical High $562.34 | Facility | None | $131.83 | $144.54 | $562.34 |
BCBS Minnesota Setting Professional Modifier None Typical Low $81.28 Median $91.20 Typical High $102.33 | Professional | None | $81.28 | $91.20 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $234.42 Typical High $446.68 | Facility | None | $151.36 | $234.42 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $104.71 Typical High $128.82 | Professional | None | $102.33 | $104.71 | $128.82 |
Health Partners Setting Facility Modifier None Typical Low $134.90 Median $218.78 Typical High $380.19 | Facility | None | $134.90 | $218.78 | $380.19 |
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 $134.90 Median $316.23 Typical High $478.63 | Facility | None | $134.90 | $316.23 | $478.63 |
Medica Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $457.09 | Professional | None | $58.88 | $58.88 | $457.09 |
United Setting Facility Modifier None Typical Low $371.54 Median $398.11 Typical High $524.81 | Facility | None | $371.54 | $398.11 | $524.81 |
United Setting Professional Modifier None Typical Low $58.88 Median $288.40 Typical High $371.54 | Professional | None | $58.88 | $288.40 | $371.54 |
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 $50.12 Median $50.12 Typical High $50.12 | Facility | 52 · Reduced service | $50.12 | $50.12 | $50.12 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $20.42 Median $20.42 Typical High $20.42 | Facility | 53 · Discontinued | $20.42 | $20.42 | $20.42 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $15.14 | Facility | 55 · Aftercare only | $15.14 | $15.14 | $15.14 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.00 Typical High $10.00 | Facility | 56 · Pre-op care only | $10.00 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $50.12 Typical High $50.12 | Professional | 52 · Reduced service | $40.74 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $20.42 Typical High $20.42 | Professional | 53 · Discontinued | $16.22 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $15.14 Typical High $15.14 | Professional | 55 · Aftercare only | $12.02 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $10.00 Typical High $10.00 | Professional | 56 · Pre-op care only | $8.13 | $10.00 | $10.00 |
Where Minnesota sits
The same service costs 13.8 times more in Indiana than in Pennsylvania. 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· 15th of 51
$102
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.