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 $0.46 Median $7.76 Typical High $11.48 | Facility | None | $0.46 | $7.76 | $11.48 |
Aetna Setting Professional Modifier None Typical Low $0.31 Median $0.46 Typical High $0.46 | Professional | None | $0.31 | $0.46 | $0.46 |
BCBS Minnesota Setting Facility Modifier None Typical Low $0.52 Median $0.72 Typical High $1.12 | Facility | None | $0.52 | $0.72 | $1.12 |
BCBS Minnesota Setting Professional Modifier None Typical Low $0.50 Median $0.62 Typical High $0.63 | Professional | None | $0.50 | $0.62 | $0.63 |
Cigna Setting Facility Modifier None Typical Low $1.12 Median $1.74 Typical High $3.31 | Facility | None | $1.12 | $1.74 | $3.31 |
Cigna Setting Professional Modifier None Typical Low $0.76 Median $0.79 Typical High $0.95 | Professional | None | $0.76 | $0.79 | $0.95 |
Health Partners Setting Facility Modifier None Typical Low $1.00 Median $1.62 Typical High $2.82 | Facility | None | $1.00 | $1.62 | $2.82 |
Health Partners Setting Professional Modifier None Typical Low $0.76 Median $0.76 Typical High $0.76 | Professional | None | $0.76 | $0.76 | $0.76 |
Medica Setting Facility Modifier None Typical Low $0.62 Median $0.62 Typical High $83.18 | Facility | None | $0.62 | $0.62 | $83.18 |
Medica Setting Professional Modifier None Typical Low $0.18 Median $0.26 Typical High $4.27 | Professional | None | $0.18 | $0.26 | $4.27 |
United Setting Professional Modifier None Typical Low $0.17 Median $0.26 Typical High $0.51 | Professional | None | $0.17 | $0.26 | $0.51 |
10 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 $0.23 Median $0.23 Typical High $0.23 | Facility | 52 · Reduced service | $0.23 | $0.23 | $0.23 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.09 Median $0.09 Typical High $0.09 | Facility | 53 · Discontinued | $0.09 | $0.09 | $0.09 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.07 Median $0.07 Typical High $0.07 | Facility | 55 · Aftercare only | $0.07 | $0.07 | $0.07 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.05 Typical High $0.05 | Facility | 56 · Pre-op care only | $0.05 | $0.05 | $0.05 |
Aetna Setting Facility Modifier RR · Rental Typical Low $0.05 Median $0.05 Typical High $0.05 | Facility | RR · Rental | $0.05 | $0.05 | $0.05 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.22 Median $0.23 Typical High $0.23 | Professional | 52 · Reduced service | $0.22 | $0.23 | $0.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | 53 · Discontinued | $0.09 | $0.09 | $0.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 55 · Aftercare only | $0.07 | $0.07 | $0.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.05 | $0.05 | $0.05 |
Aetna Setting Professional Modifier RR · Rental Typical Low $0.05 Median $0.05 Typical High $0.06 | Professional | RR · Rental | $0.05 | $0.05 | $0.06 |
Where Minnesota sits
The same service costs 4.6 times more in Hawaii than in Rhode Island. 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· 4th of 51
$0.63
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.