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 $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
BCBS Setting Facility Modifier None Typical Low $125.89 Median $234.42 Typical High $234.42 | Facility | None | $125.89 | $234.42 | $234.42 |
BCBS Setting Professional Modifier None Typical Low $181.97 Median $208.93 Typical High $257.04 | Professional | None | $181.97 | $208.93 | $257.04 |
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 |
9 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 $61.66 Median $61.66 Typical High $61.66 | Facility | 52 · Reduced service | $61.66 | $61.66 | $61.66 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $24.55 Median $24.55 Typical High $24.55 | Facility | 53 · Discontinued | $24.55 | $24.55 | $24.55 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $18.62 | Facility | 55 · Aftercare only | $18.62 | $18.62 | $18.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.30 Typical High $12.30 | Facility | 56 · Pre-op care only | $12.30 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | 52 · Reduced service | $61.66 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | 53 · Discontinued | $24.55 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | 55 · Aftercare only | $18.62 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | 56 · Pre-op care only | $12.30 | $12.30 | $12.30 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $177.83 Typical High $275.42 | Professional | 54 · Surgery only | $125.89 | $177.83 | $275.42 |
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· 2nd of 51
$182
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.