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 $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
Aetna Setting Professional Modifier None Typical Low $23.44 Median $24.55 Typical High $33.11 | Professional | None | $23.44 | $24.55 | $33.11 |
BCBS Minnesota Setting Facility Modifier None Typical Low $30.20 Median $33.11 Typical High $54.95 | Facility | None | $30.20 | $33.11 | $54.95 |
BCBS Minnesota Setting Professional Modifier None Typical Low $26.92 Median $30.20 Typical High $33.88 | Professional | None | $26.92 | $30.20 | $33.88 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $93.33 Typical High $288.40 | Facility | None | $57.54 | $93.33 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $40.74 Typical High $48.98 | Professional | None | $38.90 | $40.74 | $48.98 |
Health Partners Setting Facility Modifier None Typical Low $51.29 Median $83.18 Typical High $151.36 | Facility | None | $51.29 | $83.18 | $151.36 |
Health Partners Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | None | $38.90 | $38.90 | $38.90 |
Medica Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $47.86 | Facility | None | $33.11 | $33.11 | $47.86 |
Medica Setting Professional Modifier None Typical Low $10.96 Median $14.13 Typical High $338.84 | Professional | None | $10.96 | $14.13 | $338.84 |
United Setting Professional Modifier None Typical Low $9.33 Median $13.80 Typical High $27.54 | Professional | None | $9.33 | $13.80 | $27.54 |
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 $12.30 Median $12.30 Typical High $12.30 | Facility | 52 · Reduced service | $12.30 | $12.30 | $12.30 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $4.90 Median $4.90 Typical High $4.90 | Facility | 53 · Discontinued | $4.90 | $4.90 | $4.90 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $18.62 Median $18.62 Typical High $18.62 | Facility | 54 · Surgery only | $18.62 | $18.62 | $18.62 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $3.72 | Facility | 55 · Aftercare only | $3.72 | $3.72 | $3.72 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $2.45 | Facility | 56 · Pre-op care only | $2.45 | $2.45 | $2.45 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.02 Median $12.30 Typical High $12.30 | Professional | 52 · Reduced service | $12.02 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $4.90 Typical High $4.90 | Professional | 53 · Discontinued | $4.79 | $4.90 | $4.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $18.20 Median $18.62 Typical High $18.62 | Professional | 54 · Surgery only | $18.20 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $3.72 Typical High $3.72 | Professional | 55 · Aftercare only | $3.63 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.40 Median $2.45 Typical High $2.45 | Professional | 56 · Pre-op care only | $2.40 | $2.45 | $2.45 |
Where Minnesota sits
The same service costs 2.6 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· 5th of 51
$33.88
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.