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 $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $19.50 | Professional | None | $18.62 | $18.62 | $19.50 |
BCBS Minnesota Setting Facility Modifier None Typical Low $36.31 Median $52.48 Typical High $54.95 | Facility | None | $36.31 | $52.48 | $54.95 |
BCBS Minnesota Setting Professional Modifier None Typical Low $16.22 Median $20.42 Typical High $29.51 | Professional | None | $16.22 | $20.42 | $29.51 |
Cigna Setting Facility Modifier None Typical Low $27.54 Median $28.84 Typical High $34.67 | Facility | None | $27.54 | $28.84 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $19.05 Median $19.50 Typical High $23.99 | Professional | None | $19.05 | $19.50 | $23.99 |
Health Partners Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $27.54 | Facility | None | $26.92 | $26.92 | $27.54 |
Health Partners Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | None | $19.05 | $19.05 | $19.05 |
Medica Setting Facility Modifier None Typical Low $30.20 Median $50.12 Typical High $56.23 | Facility | None | $30.20 | $50.12 | $56.23 |
Medica Setting Professional Modifier None Typical Low $30.20 Median $31.62 Typical High $53.70 | Professional | None | $30.20 | $31.62 | $53.70 |
United Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
United Setting Professional Modifier None Typical Low $20.42 Median $21.38 Typical High $33.11 | Professional | None | $20.42 | $21.38 | $33.11 |
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 $9.33 Median $9.33 Typical High $9.33 | Facility | 52 · Reduced service | $9.33 | $9.33 | $9.33 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $3.72 Median $3.72 Typical High $3.72 | Facility | 53 · Discontinued | $3.72 | $3.72 | $3.72 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $2.75 Median $2.75 Typical High $2.75 | Facility | 55 · Aftercare only | $2.75 | $2.75 | $2.75 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.86 Median $1.86 Typical High $1.86 | Facility | 56 · Pre-op care only | $1.86 | $1.86 | $1.86 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $9.33 Median $9.33 Typical High $9.55 | Professional | 52 · Reduced service | $9.33 | $9.33 | $9.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $3.72 Typical High $3.80 | Professional | 53 · Discontinued | $3.72 | $3.72 | $3.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $2.75 Typical High $2.88 | Professional | 55 · Aftercare only | $2.75 | $2.75 | $2.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $1.86 Typical High $1.91 | Professional | 56 · Pre-op care only | $1.86 | $1.86 | $1.91 |
Where Minnesota sits
The same service costs 1.8 times more in Hawaii than in Ohio. 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· 13th of 51
$20.42
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.