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 $31.62 Median $31.62 Typical High $31.62 | Facility | None | $31.62 | $31.62 | $31.62 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $35.48 | Professional | None | $31.62 | $31.62 | $35.48 |
BCBS Minnesota Setting Facility Modifier None Typical Low $48.98 Median $81.28 Typical High $104.71 | Facility | None | $48.98 | $81.28 | $104.71 |
BCBS Minnesota Setting Professional Modifier None Typical Low $28.84 Median $35.48 Typical High $41.69 | Professional | None | $28.84 | $35.48 | $41.69 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $51.29 Typical High $61.66 | Facility | None | $48.98 | $51.29 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $33.88 Typical High $41.69 | Professional | None | $33.11 | $33.88 | $41.69 |
Health Partners Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $48.98 | Facility | None | $47.86 | $47.86 | $48.98 |
Health Partners Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
Medica Setting Facility Modifier None Typical Low $44.67 Median $75.86 Typical High $97.72 | Facility | None | $44.67 | $75.86 | $97.72 |
Medica Setting Professional Modifier None Typical Low $44.67 Median $50.12 Typical High $234.42 | Professional | None | $44.67 | $50.12 | $234.42 |
United Setting Facility Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Facility | None | $31.62 | $31.62 | $31.62 |
United Setting Professional Modifier None Typical Low $35.48 Median $38.02 Typical High $58.88 | Professional | None | $35.48 | $38.02 | $58.88 |
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 $15.85 Median $15.85 Typical High $15.85 | Facility | 52 · Reduced service | $15.85 | $15.85 | $15.85 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $6.46 Median $6.46 Typical High $6.46 | Facility | 53 · Discontinued | $6.46 | $6.46 | $6.46 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.79 Median $4.79 Typical High $4.79 | Facility | 55 · Aftercare only | $4.79 | $4.79 | $4.79 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $3.24 | Facility | 56 · Pre-op care only | $3.24 | $3.24 | $3.24 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $15.85 Median $15.85 Typical High $16.60 | Professional | 52 · Reduced service | $15.85 | $15.85 | $16.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.46 Typical High $6.61 | Professional | 53 · Discontinued | $6.46 | $6.46 | $6.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $4.79 Typical High $4.90 | Professional | 55 · Aftercare only | $4.79 | $4.79 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $3.31 | Professional | 56 · Pre-op care only | $3.24 | $3.24 | $3.31 |
Where Minnesota sits
The same service costs 1.7 times more in Hawaii 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· 15th of 51
$35.48
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.