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 $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $54.95 Typical High $54.95 | Professional | None | $53.70 | $54.95 | $54.95 |
BCBS Minnesota Setting Facility Modifier None Typical Low $66.07 Median $74.13 Typical High $120.23 | Facility | None | $66.07 | $74.13 | $120.23 |
BCBS Minnesota Setting Professional Modifier None Typical Low $60.26 Median $67.61 Typical High $75.86 | Professional | None | $60.26 | $67.61 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $204.17 Typical High $645.65 | Facility | None | $128.82 | $204.17 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $91.20 Typical High $109.65 | Professional | None | $87.10 | $91.20 | $109.65 |
Health Partners Setting Facility Modifier None Typical Low $114.82 Median $181.97 Typical High $338.84 | Facility | None | $114.82 | $181.97 | $338.84 |
Health Partners Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
Medica Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $107.15 | Facility | None | $74.13 | $74.13 | $107.15 |
Medica Setting Professional Modifier None Typical Low $23.99 Median $31.62 Typical High $645.65 | Professional | None | $23.99 | $31.62 | $645.65 |
United Setting Professional Modifier None Typical Low $20.89 Median $30.90 Typical High $61.66 | Professional | None | $20.89 | $30.90 | $61.66 |
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 $27.54 Median $27.54 Typical High $27.54 | Facility | 52 · Reduced service | $27.54 | $27.54 | $27.54 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $10.96 Median $10.96 Typical High $10.96 | Facility | 53 · Discontinued | $10.96 | $10.96 | $10.96 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $40.74 Median $40.74 Typical High $40.74 | Facility | 54 · Surgery only | $40.74 | $40.74 | $40.74 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.13 Median $8.13 Typical High $8.13 | Facility | 55 · Aftercare only | $8.13 | $8.13 | $8.13 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.50 Typical High $5.50 | Facility | 56 · Pre-op care only | $5.50 | $5.50 | $5.50 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $26.92 Median $27.54 Typical High $27.54 | Professional | 52 · Reduced service | $26.92 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.96 Typical High $10.96 | Professional | 53 · Discontinued | $10.72 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $40.74 Typical High $40.74 | Professional | 54 · Surgery only | $39.81 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | 55 · Aftercare only | $8.13 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.50 Typical High $5.50 | Professional | 56 · Pre-op care only | $5.37 | $5.50 | $5.50 |
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· 3rd of 51
$75.86
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.