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 $2.51 Median $2.51 Typical High $2.51 | Facility | None | $2.51 | $2.51 | $2.51 |
Aetna Setting Professional Modifier None Typical Low $2.45 Median $2.51 Typical High $2.51 | Professional | None | $2.45 | $2.51 | $2.51 |
BCBS Minnesota Setting Facility Modifier None Typical Low $3.09 Median $4.07 Typical High $6.46 | Facility | None | $3.09 | $4.07 | $6.46 |
BCBS Minnesota Setting Professional Modifier None Typical Low $2.82 Median $3.31 Typical High $3.63 | Professional | None | $2.82 | $3.31 | $3.63 |
Cigna Setting Facility Modifier None Typical Low $5.62 Median $8.71 Typical High $16.60 | Facility | None | $5.62 | $8.71 | $16.60 |
Cigna Setting Professional Modifier None Typical Low $3.80 Median $3.98 Typical High $4.79 | Professional | None | $3.80 | $3.98 | $4.79 |
Health Partners Setting Facility Modifier None Typical Low $5.01 Median $8.13 Typical High $14.13 | Facility | None | $5.01 | $8.13 | $14.13 |
Health Partners Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | None | $3.72 | $3.72 | $3.72 |
Medica Setting Facility Modifier None Typical Low $3.39 Median $3.39 Typical High $4.90 | Facility | None | $3.39 | $3.39 | $4.90 |
Medica Setting Professional Modifier None Typical Low $1.12 Median $1.70 Typical High $16.98 | Professional | None | $1.12 | $1.70 | $16.98 |
United Setting Professional Modifier None Typical Low $1.12 Median $1.41 Typical High $3.02 | Professional | None | $1.12 | $1.41 | $3.02 |
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 $1.26 Median $1.26 Typical High $1.26 | Facility | 52 · Reduced service | $1.26 | $1.26 | $1.26 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.50 Median $0.50 Typical High $0.50 | Facility | 53 · Discontinued | $0.50 | $0.50 | $0.50 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.38 Median $0.38 Typical High $0.38 | Facility | 55 · Aftercare only | $0.38 | $0.38 | $0.38 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.25 Median $0.25 Typical High $0.25 | Facility | 56 · Pre-op care only | $0.25 | $0.25 | $0.25 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.23 Median $1.26 Typical High $1.26 | Professional | 52 · Reduced service | $1.23 | $1.26 | $1.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.49 Median $0.50 Typical High $0.50 | Professional | 53 · Discontinued | $0.49 | $0.50 | $0.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.37 Median $0.38 Typical High $0.38 | Professional | 55 · Aftercare only | $0.37 | $0.38 | $0.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.25 Median $0.25 Typical High $0.25 | Professional | 56 · Pre-op care only | $0.25 | $0.25 | $0.25 |
Where Minnesota sits
The same service costs 2.3 times more in Hawaii than in Kentucky. 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
$3.63
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.