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 $34.67 Median $34.67 Typical High $34.67 | Facility | None | $34.67 | $34.67 | $34.67 |
Aetna Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
BCBS Minnesota Setting Facility Modifier None Typical Low $42.66 Median $46.77 Typical High $77.62 | Facility | None | $42.66 | $46.77 | $77.62 |
BCBS Minnesota Setting Professional Modifier None Typical Low $38.90 Median $43.65 Typical High $47.86 | Professional | None | $38.90 | $43.65 | $47.86 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $131.83 Typical High $416.87 | Facility | None | $81.28 | $131.83 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $57.54 Typical High $69.18 | Professional | None | $54.95 | $57.54 | $69.18 |
Health Partners Setting Facility Modifier None Typical Low $72.44 Median $117.49 Typical High $213.80 | Facility | None | $72.44 | $117.49 | $213.80 |
Health Partners Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Medica Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $74.13 | Facility | None | $46.77 | $46.77 | $74.13 |
Medica Setting Professional Modifier None Typical Low $15.14 Median $19.95 Typical High $616.60 | Professional | None | $15.14 | $19.95 | $616.60 |
United Setting Professional Modifier None Typical Low $13.49 Median $19.50 Typical High $38.90 | Professional | None | $13.49 | $19.50 | $38.90 |
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 $17.38 Median $17.38 Typical High $17.38 | Facility | 52 · Reduced service | $17.38 | $17.38 | $17.38 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $6.92 Median $6.92 Typical High $6.92 | Facility | 53 · Discontinued | $6.92 | $6.92 | $6.92 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $26.30 Median $26.30 Typical High $26.30 | Facility | 54 · Surgery only | $26.30 | $26.30 | $26.30 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.25 Median $5.25 Typical High $5.25 | Facility | 55 · Aftercare only | $5.25 | $5.25 | $5.25 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.47 Median $3.47 Typical High $3.47 | Facility | 56 · Pre-op care only | $3.47 | $3.47 | $3.47 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $16.98 Median $17.38 Typical High $17.38 | Professional | 52 · Reduced service | $16.98 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | 53 · Discontinued | $6.92 | $6.92 | $6.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $25.70 Median $26.30 Typical High $26.30 | Professional | 54 · Surgery only | $25.70 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.25 Typical High $5.25 | Professional | 55 · Aftercare only | $5.13 | $5.25 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | 56 · Pre-op care only | $3.47 | $3.47 | $3.47 |
Where Minnesota sits
The same service costs 3.2 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· 5th of 51
$47.86
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.