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 $32.36 Median $32.36 Typical High $32.36 | Facility | None | $32.36 | $32.36 | $32.36 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $32.36 Typical High $32.36 | Professional | None | $31.62 | $32.36 | $32.36 |
BCBS Minnesota Setting Facility Modifier None Typical Low $39.81 Median $43.65 Typical High $72.44 | Facility | None | $39.81 | $43.65 | $72.44 |
BCBS Minnesota Setting Professional Modifier None Typical Low $35.48 Median $40.74 Typical High $44.67 | Professional | None | $35.48 | $40.74 | $44.67 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $123.03 Typical High $380.19 | Facility | None | $75.86 | $123.03 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $53.70 Typical High $64.57 | Professional | None | $51.29 | $53.70 | $64.57 |
Health Partners Setting Facility Modifier None Typical Low $67.61 Median $109.65 Typical High $199.53 | Facility | None | $67.61 | $109.65 | $199.53 |
Health Partners Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | None | $51.29 | $51.29 | $51.29 |
Medica Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $63.10 | Facility | None | $43.65 | $43.65 | $63.10 |
Medica Setting Professional Modifier None Typical Low $14.13 Median $18.62 Typical High $398.11 | Professional | None | $14.13 | $18.62 | $398.11 |
United Setting Professional Modifier None Typical Low $12.30 Median $18.20 Typical High $36.31 | Professional | None | $12.30 | $18.20 | $36.31 |
10 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 $16.22 Median $16.22 Typical High $16.22 | Facility | 52 · Reduced service | $16.22 | $16.22 | $16.22 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $6.46 Median $6.46 Typical High $6.46 | Facility | 53 · Discontinued | $6.46 | $6.46 | $6.46 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $24.55 Median $24.55 Typical High $24.55 | Facility | 54 · Surgery only | $24.55 | $24.55 | $24.55 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.90 Median $4.90 Typical High $4.90 | Facility | 55 · Aftercare only | $4.90 | $4.90 | $4.90 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $3.24 | Facility | 56 · Pre-op care only | $3.24 | $3.24 | $3.24 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $15.85 Median $16.22 Typical High $16.22 | Professional | 52 · Reduced service | $15.85 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | 53 · Discontinued | $6.46 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $23.99 Median $24.55 Typical High $24.55 | Professional | 54 · Surgery only | $23.99 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $4.90 Typical High $4.90 | Professional | 55 · Aftercare only | $4.79 | $4.90 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.24 Typical High $3.24 | Professional | 56 · Pre-op care only | $3.16 | $3.24 | $3.24 |
Where Minnesota sits
The same service costs 2.7 times more in Hawaii 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· 3rd of 51
$44.67
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.