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 $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $35.48 Typical High $35.48 | Professional | None | $30.20 | $35.48 | $35.48 |
BCBS Minnesota Setting Facility Modifier None Typical Low $42.66 Median $47.86 Typical High $77.62 | Facility | None | $42.66 | $47.86 | $77.62 |
BCBS Minnesota Setting Professional Modifier None Typical Low $38.90 Median $43.65 Typical High $48.98 | Professional | None | $38.90 | $43.65 | $48.98 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $131.83 Typical High $416.87 | Facility | None | $83.18 | $131.83 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $58.88 Typical High $70.79 | Professional | None | $56.23 | $58.88 | $70.79 |
Health Partners Setting Facility Modifier None Typical Low $74.13 Median $117.49 Typical High $218.78 | Facility | None | $74.13 | $117.49 | $218.78 |
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 $47.86 Median $47.86 Typical High $69.18 | Facility | None | $47.86 | $47.86 | $69.18 |
Medica Setting Professional Modifier None Typical Low $15.85 Median $19.95 Typical High $316.23 | Professional | None | $15.85 | $19.95 | $316.23 |
United Setting Professional Modifier None Typical Low $13.49 Median $19.95 Typical High $39.81 | Professional | None | $13.49 | $19.95 | $39.81 |
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 $7.08 Median $7.08 Typical High $7.08 | Facility | 53 · Discontinued | $7.08 | $7.08 | $7.08 |
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 $3.55 Median $3.55 Typical High $3.55 | Facility | 56 · Pre-op care only | $3.55 | $3.55 | $3.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | 52 · Reduced service | $17.38 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $7.08 Typical High $7.08 | Professional | 53 · Discontinued | $6.92 | $7.08 | $7.08 |
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 $3.55 Typical High $3.55 | Professional | 56 · Pre-op care only | $3.47 | $3.55 | $3.55 |
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· 5th of 51
$48.98
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.