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 $0.25 Median $0.25 Typical High $0.25 | Facility | None | $0.25 | $0.25 | $0.25 |
Aetna Setting Professional Modifier None Typical Low $0.25 Median $0.25 Typical High $0.27 | Professional | None | $0.25 | $0.25 | $0.27 |
BCBS Minnesota Setting Facility Modifier None Typical Low $0.48 Median $0.62 Typical High $1.02 | Facility | None | $0.48 | $0.62 | $1.02 |
BCBS Minnesota Setting Professional Modifier AU · Urologic/ostomy supply + AV · With prosthetic/orthotic + AW · With surgical dressing Typical Low $0.43 Median $0.52 Typical High $0.54 | Professional | AU · Urologic/ostomy supply + AV · With prosthetic/orthotic + AW · With surgical dressing | $0.43 | $0.52 | $0.54 |
Cigna Setting Facility Modifier None Typical Low $0.56 Median $0.87 Typical High $1.66 | Facility | None | $0.56 | $0.87 | $1.66 |
Cigna Setting Professional Modifier None Typical Low $0.38 Median $0.40 Typical High $0.48 | Professional | None | $0.38 | $0.40 | $0.48 |
Health Partners Setting Facility Modifier None Typical Low $0.50 Median $0.81 Typical High $1.41 | Facility | None | $0.50 | $0.81 | $1.41 |
Health Partners Setting Professional Modifier None Typical Low $0.38 Median $0.38 Typical High $0.38 | Professional | None | $0.38 | $0.38 | $0.38 |
Medica Setting Facility Modifier None Typical Low $0.46 Median $0.52 Typical High $0.63 | Facility | None | $0.46 | $0.52 | $0.63 |
Medica Setting Professional Modifier None Typical Low $0.17 Median $0.23 Typical High $39.81 | Professional | None | $0.17 | $0.23 | $39.81 |
United Setting Professional Modifier None Typical Low $0.15 Median $0.23 Typical High $0.45 | Professional | None | $0.15 | $0.23 | $0.45 |
6 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 55 · Aftercare only Typical Low $0.04 Median $0.04 Typical High $0.04 | Facility | 55 · Aftercare only | $0.04 | $0.04 | $0.04 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.03 | Facility | 56 · Pre-op care only | $0.03 | $0.03 | $0.03 |
Aetna Setting Facility Modifier AW · With surgical dressing Typical Low $0.15 Median $0.15 Typical High $0.15 | Facility | AW · With surgical dressing | $0.15 | $0.15 | $0.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | 55 · Aftercare only | $0.04 | $0.04 | $0.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | 56 · Pre-op care only | $0.03 | $0.03 | $0.03 |
Aetna Setting Professional Modifier AW · With surgical dressing Typical Low $0.15 Median $0.15 Typical High $0.15 | Professional | AW · With surgical dressing | $0.15 | $0.15 | $0.15 |
Where Minnesota sits
The same service costs 2.5 times more in Montana than in Colorado. 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· 9th of 51
$0.38
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.