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 $19.05 Median $19.05 Typical High $19.05 | Facility | None | $19.05 | $19.05 | $19.05 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $19.05 Typical High $19.05 | Professional | None | $18.62 | $19.05 | $19.05 |
BCBS Minnesota Setting Facility Modifier None Typical Low $23.44 Median $25.70 Typical High $42.66 | Facility | None | $23.44 | $25.70 | $42.66 |
BCBS Minnesota Setting Professional Modifier None Typical Low $20.89 Median $23.44 Typical High $26.30 | Professional | None | $20.89 | $23.44 | $26.30 |
Cigna Setting Facility Modifier None Typical Low $44.67 Median $72.44 Typical High $223.87 | Facility | None | $44.67 | $72.44 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $31.62 Typical High $38.02 | Professional | None | $30.20 | $31.62 | $38.02 |
Health Partners Setting Facility Modifier None Typical Low $39.81 Median $64.57 Typical High $117.49 | Facility | None | $39.81 | $64.57 | $117.49 |
Health Partners Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Medica Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $44.67 | Facility | None | $25.70 | $25.70 | $44.67 |
Medica Setting Professional Modifier None Typical Low $8.51 Median $10.96 Typical High $363.08 | Professional | None | $8.51 | $10.96 | $363.08 |
United Setting Professional Modifier None Typical Low $7.24 Median $10.72 Typical High $21.38 | Professional | None | $7.24 | $10.72 | $21.38 |
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 $9.55 Median $9.55 Typical High $9.55 | Facility | 52 · Reduced service | $9.55 | $9.55 | $9.55 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $3.80 Median $3.80 Typical High $3.80 | Facility | 53 · Discontinued | $3.80 | $3.80 | $3.80 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $14.13 Median $14.13 Typical High $14.13 | Facility | 54 · Surgery only | $14.13 | $14.13 | $14.13 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $2.82 Median $2.82 Typical High $2.82 | Facility | 55 · Aftercare only | $2.82 | $2.82 | $2.82 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.91 Median $1.91 Typical High $1.91 | Facility | 56 · Pre-op care only | $1.91 | $1.91 | $1.91 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $9.33 Median $9.55 Typical High $9.55 | Professional | 52 · Reduced service | $9.33 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $3.80 Typical High $3.80 | Professional | 53 · Discontinued | $3.72 | $3.80 | $3.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | 54 · Surgery only | $14.13 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | 55 · Aftercare only | $2.82 | $2.82 | $2.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $1.91 Typical High $1.91 | Professional | 56 · Pre-op care only | $1.86 | $1.91 | $1.91 |
Where Minnesota sits
The same service costs 3.5 times more in Rhode Island 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
$26.30
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.