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 $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $30.90 Typical High $30.90 | Professional | None | $29.51 | $30.90 | $30.90 |
BCBS Minnesota Setting Facility Modifier None Typical Low $38.02 Median $41.69 Typical High $69.18 | Facility | None | $38.02 | $41.69 | $69.18 |
BCBS Minnesota Setting Professional Modifier None Typical Low $33.88 Median $38.90 Typical High $42.66 | Professional | None | $33.88 | $38.90 | $42.66 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $117.49 Typical High $371.54 | Facility | None | $72.44 | $117.49 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $51.29 Typical High $61.66 | Professional | None | $48.98 | $51.29 | $61.66 |
Health Partners Setting Facility Modifier None Typical Low $64.57 Median $104.71 Typical High $190.55 | Facility | None | $64.57 | $104.71 | $190.55 |
Health Partners Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
Medica Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $60.26 | Facility | None | $41.69 | $41.69 | $60.26 |
Medica Setting Professional Modifier None Typical Low $13.49 Median $17.78 Typical High $269.15 | Professional | None | $13.49 | $17.78 | $269.15 |
United Setting Professional Modifier None Typical Low $11.75 Median $17.38 Typical High $34.67 | Professional | None | $11.75 | $17.38 | $34.67 |
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 $15.49 Median $15.49 Typical High $15.49 | Facility | 52 · Reduced service | $15.49 | $15.49 | $15.49 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $6.17 Median $6.17 Typical High $6.17 | Facility | 53 · Discontinued | $6.17 | $6.17 | $6.17 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $23.44 Median $23.44 Typical High $23.44 | Facility | 54 · Surgery only | $23.44 | $23.44 | $23.44 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.68 Median $4.68 Typical High $4.68 | Facility | 55 · Aftercare only | $4.68 | $4.68 | $4.68 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $3.09 | Facility | 56 · Pre-op care only | $3.09 | $3.09 | $3.09 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $15.14 Median $15.49 Typical High $15.49 | Professional | 52 · Reduced service | $15.14 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | 53 · Discontinued | $6.17 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $22.91 Median $23.44 Typical High $23.44 | Professional | 54 · Surgery only | $22.91 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $4.68 Typical High $4.68 | Professional | 55 · Aftercare only | $4.57 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.09 Typical High $3.09 | Professional | 56 · Pre-op care only | $3.02 | $3.09 | $3.09 |
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· 4th of 51
$42.66
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.