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 $26.92 Median $26.92 Typical High $26.92 | Facility | None | $26.92 | $26.92 | $26.92 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $26.92 Typical High $58.88 | Professional | None | $26.30 | $26.92 | $58.88 |
BCBS Minnesota Setting Facility Modifier None Typical Low $33.11 Median $36.31 Typical High $60.26 | Facility | None | $33.11 | $36.31 | $60.26 |
BCBS Minnesota Setting Professional Modifier None Typical Low $29.51 Median $33.11 Typical High $37.15 | Professional | None | $29.51 | $33.11 | $37.15 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $102.33 Typical High $316.23 | Facility | None | $63.10 | $102.33 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $44.67 Typical High $53.70 | Professional | None | $42.66 | $44.67 | $53.70 |
Health Partners Setting Facility Modifier None Typical Low $56.23 Median $91.20 Typical High $165.96 | Facility | None | $56.23 | $91.20 | $165.96 |
Health Partners Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
Medica Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $56.23 | Facility | None | $36.31 | $36.31 | $56.23 |
Medica Setting Professional Modifier None Typical Low $12.02 Median $15.49 Typical High $457.09 | Professional | None | $12.02 | $15.49 | $457.09 |
United Setting Professional Modifier None Typical Low $10.23 Median $15.14 Typical High $30.20 | Professional | None | $10.23 | $15.14 | $30.20 |
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 $13.49 Median $13.49 Typical High $13.49 | Facility | 52 · Reduced service | $13.49 | $13.49 | $13.49 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $5.37 Median $5.37 Typical High $5.37 | Facility | 53 · Discontinued | $5.37 | $5.37 | $5.37 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $20.42 Median $20.42 Typical High $20.42 | Facility | 54 · Surgery only | $20.42 | $20.42 | $20.42 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.07 Median $4.07 Typical High $4.07 | Facility | 55 · Aftercare only | $4.07 | $4.07 | $4.07 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.69 Median $2.69 Typical High $2.69 | Facility | 56 · Pre-op care only | $2.69 | $2.69 | $2.69 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $13.18 Median $13.49 Typical High $13.49 | Professional | 52 · Reduced service | $13.18 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | 53 · Discontinued | $5.37 | $5.37 | $5.37 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.95 Median $20.42 Typical High $20.42 | Professional | 54 · Surgery only | $19.95 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $4.07 Typical High $4.07 | Professional | 55 · Aftercare only | $3.98 | $4.07 | $4.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $2.69 Typical High $2.69 | Professional | 56 · Pre-op care only | $2.63 | $2.69 | $2.69 |
Where Minnesota sits
The same service costs 3.1 times more in Rhode Island 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· 7th of 51
$37.15
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.