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 $17.38 Median $17.38 Typical High $17.38 | Facility | None | $17.38 | $17.38 | $17.38 |
Aetna Setting Professional Modifier None Typical Low $15.85 Median $17.38 Typical High $17.38 | Professional | None | $15.85 | $17.38 | $17.38 |
BCBS Minnesota Setting Facility Modifier None Typical Low $20.89 Median $23.44 Typical High $38.02 | Facility | None | $20.89 | $23.44 | $38.02 |
BCBS Minnesota Setting Professional Modifier None Typical Low $19.05 Median $23.44 Typical High $23.99 | Professional | None | $19.05 | $23.44 | $23.99 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $64.57 Typical High $204.17 | Facility | None | $40.74 | $64.57 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $27.54 Median $28.84 Typical High $34.67 | Professional | None | $27.54 | $28.84 | $34.67 |
Health Partners Setting Facility Modifier None Typical Low $36.31 Median $57.54 Typical High $107.15 | Facility | None | $36.31 | $57.54 | $107.15 |
Health Partners Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
Medica Setting Facility Modifier None Typical Low $23.44 Median $23.44 Typical High $74.13 | Facility | None | $23.44 | $23.44 | $74.13 |
Medica Setting Professional Modifier None Typical Low $7.76 Median $9.77 Typical High $269.15 | Professional | None | $7.76 | $9.77 | $269.15 |
United Setting Professional Modifier None Typical Low $6.61 Median $9.77 Typical High $19.50 | Professional | None | $6.61 | $9.77 | $19.50 |
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 $8.71 Median $8.71 Typical High $8.71 | Facility | 52 · Reduced service | $8.71 | $8.71 | $8.71 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $3.47 Median $3.47 Typical High $3.47 | Facility | 53 · Discontinued | $3.47 | $3.47 | $3.47 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $12.88 Median $12.88 Typical High $12.88 | Facility | 54 · Surgery only | $12.88 | $12.88 | $12.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $2.57 Median $2.57 Typical High $2.57 | Facility | 55 · Aftercare only | $2.57 | $2.57 | $2.57 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.74 Median $1.74 Typical High $1.74 | Facility | 56 · Pre-op care only | $1.74 | $1.74 | $1.74 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $8.51 Median $8.71 Typical High $8.71 | Professional | 52 · Reduced service | $8.51 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.39 Median $3.47 Typical High $3.47 | Professional | 53 · Discontinued | $3.39 | $3.47 | $3.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $12.59 Median $12.88 Typical High $12.88 | Professional | 54 · Surgery only | $12.59 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $2.57 Typical High $2.57 | Professional | 55 · Aftercare only | $2.51 | $2.57 | $2.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.70 Median $1.74 Typical High $1.74 | Professional | 56 · Pre-op care only | $1.70 | $1.74 | $1.74 |
Where Minnesota sits
The same service costs 2.9 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· 6th of 51
$23.44
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.