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 $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $302.00 Typical High $302.00 | Professional | None | $134.90 | $302.00 | $302.00 |
BCBS Minnesota Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $436.52 | Facility | None | $234.42 | $234.42 | $436.52 |
BCBS Minnesota Setting Professional Modifier None Typical Low $151.36 Median $199.53 Typical High $251.19 | Professional | None | $151.36 | $199.53 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $338.84 Typical High $660.69 | Facility | None | $218.78 | $338.84 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $154.88 Typical High $186.21 | Professional | None | $147.91 | $154.88 | $186.21 |
Health Partners Setting Facility Modifier None Typical Low $194.98 Median $316.23 Typical High $549.54 | Facility | None | $194.98 | $316.23 | $549.54 |
Health Partners Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $186.21 | Professional | None | $125.89 | $125.89 | $186.21 |
8 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 $151.36 Median $151.36 Typical High $151.36 | Facility | 52 · Reduced service | $151.36 | $151.36 | $151.36 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | 53 · Discontinued | $60.26 | $60.26 | $60.26 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $44.67 | Facility | 55 · Aftercare only | $44.67 | $44.67 | $44.67 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $30.20 | Facility | 56 · Pre-op care only | $30.20 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $67.61 Median $151.36 Typical High $151.36 | Professional | 52 · Reduced service | $67.61 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $26.92 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $44.67 Typical High $44.67 | Professional | 55 · Aftercare only | $20.42 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $30.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $13.49 | $30.20 | $30.20 |
Where Minnesota sits
The same service costs 2.3 times more in North Dakota than in North Carolina. 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
$186
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.