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 $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
BCBS Setting Facility Modifier None Typical Low $251.19 Median $501.19 Typical High $794.33 | Facility | None | $251.19 | $501.19 | $794.33 |
BCBS Setting Professional Modifier None Typical Low $181.97 Median $213.80 Typical High $398.11 | Professional | None | $181.97 | $213.80 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,230.27 Typical High $1,905.46 | Facility | None | $758.58 | $1,230.27 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $537.03 Typical High $645.65 | Professional | None | $512.86 | $537.03 | $645.65 |
Health Partners Setting Facility Modifier None Typical Low $676.08 Median $1,096.48 Typical High $1,862.09 | Facility | None | $676.08 | $1,096.48 | $1,862.09 |
Health Partners Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Medica Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $630.96 | Facility | None | $331.13 | $331.13 | $630.96 |
Medica Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $3,630.78 | Professional | None | $331.13 | $331.13 | $3,630.78 |
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 $239.88 Median $239.88 Typical High $239.88 | Facility | 52 · Reduced service | $239.88 | $239.88 | $239.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | 53 · Discontinued | $95.50 | $95.50 | $95.50 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | 55 · Aftercare only | $72.44 | $72.44 | $72.44 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $47.86 | Facility | 56 · Pre-op care only | $47.86 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | 52 · Reduced service | $239.88 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 53 · Discontinued | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $72.44 Typical High $72.44 | Professional | 55 · Aftercare only | $70.79 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $47.86 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $177.83 Typical High $295.12 | Professional | 54 · Surgery only | $125.89 | $177.83 | $295.12 |
Where Minnesota sits
The same service costs 12.0 times more in Wyoming 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· 14th of 51
$457
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.