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 $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $74.13 Typical High $74.13 | Professional | None | $70.79 | $74.13 | $74.13 |
BCBS Setting Facility Modifier None Typical Low $74.13 Median $117.49 Typical High $257.04 | Facility | None | $74.13 | $117.49 | $257.04 |
BCBS Setting Professional Modifier None Typical Low $74.13 Median $194.98 Typical High $239.88 | Professional | None | $74.13 | $194.98 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $177.83 Typical High $275.42 | Facility | None | $112.20 | $177.83 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $83.18 Typical High $95.50 | Professional | None | $75.86 | $83.18 | $95.50 |
Health Partners Setting Facility Modifier None Typical Low $100.00 Median $162.18 Typical High $275.42 | Facility | None | $100.00 | $162.18 | $275.42 |
Health Partners Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Medica Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $134.90 | Facility | None | $70.79 | $70.79 | $134.90 |
Medica Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $457.09 | Professional | None | $70.79 | $70.79 | $457.09 |
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 $37.15 Median $37.15 Typical High $37.15 | Facility | 52 · Reduced service | $37.15 | $37.15 | $37.15 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $14.79 Median $14.79 Typical High $14.79 | Facility | 53 · Discontinued | $14.79 | $14.79 | $14.79 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $10.96 | Facility | 55 · Aftercare only | $10.96 | $10.96 | $10.96 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.41 Typical High $7.41 | Facility | 56 · Pre-op care only | $7.41 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | 52 · Reduced service | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | 53 · Discontinued | $14.79 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | 55 · Aftercare only | $10.96 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | 56 · Pre-op care only | $7.41 | $7.41 | $7.41 |
Where Minnesota sits
The same service costs 3.6 times more in Wyoming than in Kentucky. 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· 40th of 51
$95.50
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.