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 $14.45 Median $14.45 Typical High $14.45 | Facility | None | $14.45 | $14.45 | $14.45 |
Aetna Setting Professional Modifier None Typical Low $14.13 Median $14.45 Typical High $14.45 | Professional | None | $14.13 | $14.45 | $14.45 |
BCBS Minnesota Setting Facility Modifier None Typical Low $17.78 Median $19.50 Typical High $32.36 | Facility | None | $17.78 | $19.50 | $32.36 |
BCBS Minnesota Setting Professional Modifier None Typical Low $16.22 Median $18.20 Typical High $19.95 | Professional | None | $16.22 | $18.20 | $19.95 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $54.95 Typical High $173.78 | Facility | None | $34.67 | $54.95 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $22.91 Median $23.99 Typical High $28.84 | Professional | None | $22.91 | $23.99 | $28.84 |
Health Partners Setting Facility Modifier None Typical Low $30.20 Median $48.98 Typical High $89.13 | Facility | None | $30.20 | $48.98 | $89.13 |
Health Partners Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | None | $22.91 | $22.91 | $22.91 |
Medica Setting Facility Modifier None Typical Low $19.50 Median $19.50 Typical High $28.84 | Facility | None | $19.50 | $19.50 | $28.84 |
Medica Setting Professional Modifier None Typical Low $6.31 Median $8.32 Typical High $158.49 | Professional | None | $6.31 | $8.32 | $158.49 |
United Setting Professional Modifier None Typical Low $5.62 Median $8.13 Typical High $16.22 | Professional | None | $5.62 | $8.13 | $16.22 |
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 $7.24 Median $7.24 Typical High $7.24 | Facility | 52 · Reduced service | $7.24 | $7.24 | $7.24 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.88 Median $2.88 Typical High $2.88 | Facility | 53 · Discontinued | $2.88 | $2.88 | $2.88 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $10.96 Median $10.96 Typical High $10.96 | Facility | 54 · Surgery only | $10.96 | $10.96 | $10.96 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $2.19 Median $2.19 Typical High $2.19 | Facility | 55 · Aftercare only | $2.19 | $2.19 | $2.19 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.45 Median $1.45 Typical High $1.45 | Facility | 56 · Pre-op care only | $1.45 | $1.45 | $1.45 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $7.08 Median $7.24 Typical High $7.24 | Professional | 52 · Reduced service | $7.08 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | 53 · Discontinued | $2.88 | $2.88 | $2.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $10.72 Median $10.96 Typical High $10.96 | Professional | 54 · Surgery only | $10.72 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.14 Median $2.19 Typical High $2.19 | Professional | 55 · Aftercare only | $2.14 | $2.19 | $2.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $1.45 Typical High $1.45 | Professional | 56 · Pre-op care only | $1.45 | $1.45 | $1.45 |
Where Minnesota sits
The same service costs 2.8 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· 4th of 51
$19.95
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.