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 $25.12 Median $25.12 Typical High $25.12 | Facility | None | $25.12 | $25.12 | $25.12 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $25.12 Typical High $25.12 | Professional | None | $24.55 | $25.12 | $25.12 |
BCBS Minnesota Setting Facility Modifier None Typical Low $30.20 Median $33.88 Typical High $54.95 | Facility | None | $30.20 | $33.88 | $54.95 |
BCBS Minnesota Setting Professional Modifier None Typical Low $27.54 Median $30.90 Typical High $34.67 | Professional | None | $27.54 | $30.90 | $34.67 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $93.33 Typical High $295.12 | Facility | None | $58.88 | $93.33 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $41.69 Typical High $48.98 | Professional | None | $39.81 | $41.69 | $48.98 |
Health Partners Setting Facility Modifier None Typical Low $52.48 Median $83.18 Typical High $154.88 | Facility | None | $52.48 | $83.18 | $154.88 |
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 $33.88 Median $33.88 Typical High $48.98 | Facility | None | $33.88 | $33.88 | $48.98 |
Medica Setting Professional Modifier None Typical Low $10.96 Median $14.13 Typical High $257.04 | Professional | None | $10.96 | $14.13 | $257.04 |
United Setting Professional Modifier None Typical Low $9.55 Median $14.13 Typical High $28.18 | Professional | None | $9.55 | $14.13 | $28.18 |
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 $12.59 Median $12.59 Typical High $12.59 | Facility | 52 · Reduced service | $12.59 | $12.59 | $12.59 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $5.01 Median $5.01 Typical High $5.01 | Facility | 53 · Discontinued | $5.01 | $5.01 | $5.01 |
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 $2.51 Median $2.51 Typical High $2.51 | Facility | 56 · Pre-op care only | $2.51 | $2.51 | $2.51 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.30 Median $12.59 Typical High $12.59 | Professional | 52 · Reduced service | $12.30 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $5.01 Typical High $5.01 | Professional | 53 · Discontinued | $4.90 | $5.01 | $5.01 |
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 $3.72 Median $3.72 Typical High $3.72 | Professional | 55 · Aftercare only | $3.72 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.51 Typical High $2.51 | Professional | 56 · Pre-op care only | $2.45 | $2.51 | $2.51 |
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
$34.67
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.