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 $3.24 Median $3.24 Typical High $3.24 | Facility | None | $3.24 | $3.24 | $3.24 |
Aetna Setting Facility Modifier AU · Urologic/ostomy supply Typical Low $1.20 Median $1.20 Typical High $1.20 | Facility | AU · Urologic/ostomy supply | $1.20 | $1.20 | $1.20 |
Aetna Setting Professional Modifier None Typical Low $2.82 Median $3.24 Typical High $3.24 | Professional | None | $2.82 | $3.24 | $3.24 |
Aetna Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | AU · Urologic/ostomy supply | $1.20 | $1.20 | $1.20 |
BCBS Minnesota Setting Facility Modifier None Typical Low $3.80 Median $5.13 Typical High $8.13 | Facility | None | $3.80 | $5.13 | $8.13 |
BCBS Minnesota Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $3.47 Median $4.17 Typical High $4.47 | Professional | AU · Urologic/ostomy supply | $3.47 | $4.17 | $4.47 |
Cigna Setting Facility Modifier None Typical Low $7.94 Median $12.30 Typical High $23.44 | Facility | None | $7.94 | $12.30 | $23.44 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $5.62 Typical High $6.61 | Professional | None | $5.25 | $5.62 | $6.61 |
Health Partners Setting Facility Modifier None Typical Low $7.08 Median $11.22 Typical High $19.50 | Facility | None | $7.08 | $11.22 | $19.50 |
Health Partners Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | None | $5.25 | $5.25 | $5.25 |
Medica Setting Facility Modifier None Typical Low $4.27 Median $4.37 Typical High $30.20 | Facility | None | $4.27 | $4.37 | $30.20 |
Medica Setting Professional Modifier None Typical Low $1.23 Median $1.86 Typical High $21.88 | Professional | None | $1.23 | $1.86 | $21.88 |
United Setting Professional Modifier None Typical Low $1.23 Median $1.82 Typical High $3.63 | Professional | None | $1.23 | $1.82 | $3.63 |
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 $1.62 Median $1.62 Typical High $1.62 | Facility | 52 · Reduced service | $1.62 | $1.62 | $1.62 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.65 Median $0.65 Typical High $0.65 | Facility | 53 · Discontinued | $0.65 | $0.65 | $0.65 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.49 Median $0.49 Typical High $0.49 | Facility | 55 · Aftercare only | $0.49 | $0.49 | $0.49 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.32 Median $0.32 Typical High $0.32 | Facility | 56 · Pre-op care only | $0.32 | $0.32 | $0.32 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.58 Median $1.62 Typical High $1.62 | Professional | 52 · Reduced service | $1.58 | $1.62 | $1.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.63 Median $0.65 Typical High $0.65 | Professional | 53 · Discontinued | $0.63 | $0.65 | $0.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.47 Median $0.49 Typical High $0.49 | Professional | 55 · Aftercare only | $0.47 | $0.49 | $0.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.32 Median $0.32 Typical High $0.32 | Professional | 56 · Pre-op care only | $0.32 | $0.32 | $0.32 |
Where Minnesota sits
The same service costs 4.4 times more in Minnesota than in New Hampshire. 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· 1st of 51
$5.25
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.