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 $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $38.02 Typical High $38.02 | Professional | None | $37.15 | $38.02 | $38.02 |
BCBS Minnesota Setting Facility Modifier None Typical Low $46.77 Median $51.29 Typical High $85.11 | Facility | None | $46.77 | $51.29 | $85.11 |
BCBS Minnesota Setting Professional Modifier None Typical Low $41.69 Median $46.77 Typical High $52.48 | Professional | None | $41.69 | $46.77 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $141.25 Typical High $446.68 | Facility | None | $89.13 | $141.25 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $63.10 Typical High $75.86 | Professional | None | $60.26 | $63.10 | $75.86 |
Health Partners Setting Facility Modifier None Typical Low $79.43 Median $128.82 Typical High $234.42 | Facility | None | $79.43 | $128.82 | $234.42 |
Health Partners Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Medica Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $199.53 | Facility | None | $51.29 | $51.29 | $199.53 |
Medica Setting Professional Modifier None Typical Low $16.98 Median $21.88 Typical High $724.44 | Professional | None | $16.98 | $21.88 | $724.44 |
United Setting Professional Modifier None Typical Low $14.45 Median $21.38 Typical High $42.66 | Professional | None | $14.45 | $21.38 | $42.66 |
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 $19.05 Median $19.05 Typical High $19.05 | Facility | 52 · Reduced service | $19.05 | $19.05 | $19.05 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $7.59 Median $7.59 Typical High $7.59 | Facility | 53 · Discontinued | $7.59 | $7.59 | $7.59 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $28.84 Median $28.84 Typical High $28.84 | Facility | 54 · Surgery only | $28.84 | $28.84 | $28.84 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.75 Median $5.75 Typical High $5.75 | Facility | 55 · Aftercare only | $5.75 | $5.75 | $5.75 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $3.80 | Facility | 56 · Pre-op care only | $3.80 | $3.80 | $3.80 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $18.62 Median $19.05 Typical High $19.05 | Professional | 52 · Reduced service | $18.62 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $7.59 Typical High $7.59 | Professional | 53 · Discontinued | $7.41 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.18 Median $28.84 Typical High $28.84 | Professional | 54 · Surgery only | $28.18 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.75 Typical High $5.75 | Professional | 55 · Aftercare only | $5.62 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $3.80 Typical High $3.80 | Professional | 56 · Pre-op care only | $3.72 | $3.80 | $3.80 |
Where Minnesota sits
The same service costs 2.6 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
$52.48
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.