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 $120.23 Median $316.23 Typical High $467.74 | Facility | None | $120.23 | $316.23 | $467.74 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $120.23 Typical High $120.23 | Professional | None | $117.49 | $120.23 | $120.23 |
BCBS Minnesota Setting Facility Modifier None Typical Low $144.54 Median $165.96 Typical High $309.03 | Facility | None | $144.54 | $165.96 | $309.03 |
BCBS Minnesota Setting Professional Modifier None Typical Low $117.49 Median $144.54 Typical High $144.54 | Professional | None | $117.49 | $144.54 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $524.81 Typical High $1,479.11 | Facility | None | $346.74 | $524.81 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $173.78 Typical High $208.93 | Professional | None | $165.96 | $173.78 | $208.93 |
Health Partners Setting Facility Modifier None Typical Low $309.03 Median $489.78 Typical High $1,174.90 | Facility | None | $309.03 | $489.78 | $1,174.90 |
Health Partners Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Medica Setting Facility Modifier None Typical Low $114.82 Median $218.78 Typical High $575.44 | Facility | None | $114.82 | $218.78 | $575.44 |
Medica Setting Professional Modifier None Typical Low $40.74 Median $57.54 Typical High $870.96 | Professional | None | $40.74 | $57.54 | $870.96 |
United Setting Professional Modifier None Typical Low $40.74 Median $50.12 Typical High $72.44 | Professional | None | $40.74 | $50.12 | $72.44 |
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 $60.26 Median $60.26 Typical High $60.26 | Facility | 52 · Reduced service | $60.26 | $60.26 | $60.26 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $23.99 | Facility | 53 · Discontinued | $23.99 | $23.99 | $23.99 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $18.20 | Facility | 55 · Aftercare only | $18.20 | $18.20 | $18.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $12.02 | Facility | 56 · Pre-op care only | $12.02 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $60.26 Typical High $60.26 | Professional | 52 · Reduced service | $58.88 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | 53 · Discontinued | $23.99 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $18.20 Typical High $18.20 | Professional | 55 · Aftercare only | $17.78 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $12.02 Typical High $12.02 | Professional | 56 · Pre-op care only | $11.75 | $12.02 | $12.02 |
Where Minnesota sits
The same service costs 3.4 times more in Hawaii than in New York. 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
$166
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.