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 $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $66.07 | Professional | None | $60.26 | $60.26 | $66.07 |
BCBS Minnesota Setting Facility Modifier None Typical Low $24.55 Median $69.18 Typical High $95.50 | Facility | None | $24.55 | $69.18 | $95.50 |
BCBS Minnesota Setting Professional Modifier None Typical Low $25.12 Median $51.29 Typical High $56.23 | Professional | None | $25.12 | $51.29 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $61.66 Typical High $72.44 | Facility | None | $57.54 | $61.66 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $77.62 | Professional | None | $61.66 | $61.66 | $77.62 |
Health Partners Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Health Partners Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Medica Setting Facility Modifier None Typical Low $35.48 Median $72.44 Typical High $177.83 | Facility | None | $35.48 | $72.44 | $177.83 |
Medica Setting Professional Modifier None Typical Low $43.65 Median $47.86 Typical High $162.18 | Professional | None | $43.65 | $47.86 | $162.18 |
United Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
United Setting Professional Modifier None Typical Low $56.23 Median $60.26 Typical High $93.33 | Professional | None | $56.23 | $60.26 | $93.33 |
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 $30.20 Median $30.20 Typical High $30.20 | Facility | 52 · Reduced service | $30.20 | $30.20 | $30.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $12.02 | Facility | 53 · Discontinued | $12.02 | $12.02 | $12.02 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.12 Median $9.12 Typical High $9.12 | Facility | 55 · Aftercare only | $9.12 | $9.12 | $9.12 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $6.03 | Facility | 56 · Pre-op care only | $6.03 | $6.03 | $6.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $30.20 Typical High $30.90 | Professional | 52 · Reduced service | $30.20 | $30.20 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $12.59 | Professional | 53 · Discontinued | $12.02 | $12.02 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.12 Typical High $9.33 | Professional | 55 · Aftercare only | $9.12 | $9.12 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $6.17 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $6.17 |
Where Minnesota sits
The same service costs 2.0 times more in Wyoming than in Hawaii. 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· 10th of 51
$61.66
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.