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 $3.55 Median $3.55 Typical High $3.55 | Facility | None | $3.55 | $3.55 | $3.55 |
Aetna Setting Professional Modifier None Typical Low $3.47 Median $3.55 Typical High $3.55 | Professional | None | $3.47 | $3.55 | $3.55 |
BCBS Minnesota Setting Facility Modifier None Typical Low $4.17 Median $5.62 Typical High $8.91 | Facility | None | $4.17 | $5.62 | $8.91 |
BCBS Minnesota Setting Professional Modifier None Typical Low $3.80 Median $4.79 Typical High $4.90 | Professional | None | $3.80 | $4.79 | $4.90 |
Cigna Setting Facility Modifier None Typical Low $8.51 Median $13.18 Typical High $25.12 | Facility | None | $8.51 | $13.18 | $25.12 |
Cigna Setting Professional Modifier None Typical Low $5.62 Median $6.03 Typical High $7.08 | Professional | None | $5.62 | $6.03 | $7.08 |
Health Partners Setting Facility Modifier None Typical Low $7.59 Median $12.02 Typical High $20.89 | Facility | None | $7.59 | $12.02 | $20.89 |
Health Partners Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | None | $5.62 | $5.62 | $5.62 |
Medica Setting Facility Modifier None Typical Low $4.79 Median $4.79 Typical High $6.76 | Facility | None | $4.79 | $4.79 | $6.76 |
Medica Setting Professional Modifier None Typical Low $1.55 Median $2.04 Typical High $23.44 | Professional | None | $1.55 | $2.04 | $23.44 |
United Setting Professional Modifier None Typical Low $1.35 Median $2.00 Typical High $3.98 | Professional | None | $1.35 | $2.00 | $3.98 |
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 $1.78 Median $1.78 Typical High $1.78 | Facility | 52 · Reduced service | $1.78 | $1.78 | $1.78 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.71 Median $0.71 Typical High $0.71 | Facility | 53 · Discontinued | $0.71 | $0.71 | $0.71 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.52 Median $0.52 Typical High $0.52 | Facility | 55 · Aftercare only | $0.52 | $0.52 | $0.52 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.35 Median $0.35 Typical High $0.35 | Facility | 56 · Pre-op care only | $0.35 | $0.35 | $0.35 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.74 Median $1.78 Typical High $1.78 | Professional | 52 · Reduced service | $1.74 | $1.78 | $1.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.69 Median $0.71 Typical High $0.71 | Professional | 53 · Discontinued | $0.69 | $0.71 | $0.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.52 Typical High $0.52 | Professional | 55 · Aftercare only | $0.52 | $0.52 | $0.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.35 Median $0.35 Typical High $0.35 | Professional | 56 · Pre-op care only | $0.35 | $0.35 | $0.35 |
Where Minnesota sits
The same service costs 2.6 times more in Hawaii than in Maine. 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· 5th of 51
$4.90
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.