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 $1.95 Median $1.95 Typical High $1.95 | Facility | None | $1.95 | $1.95 | $1.95 |
Aetna Setting Professional Modifier None Typical Low $1.91 Median $1.95 Typical High $1.95 | Professional | None | $1.91 | $1.95 | $1.95 |
BCBS Minnesota Setting Facility Modifier None Typical Low $2.29 Median $3.09 Typical High $4.79 | Facility | None | $2.29 | $3.09 | $4.79 |
BCBS Minnesota Setting Professional Modifier None Typical Low $2.14 Median $2.63 Typical High $2.63 | Professional | None | $2.14 | $2.63 | $2.63 |
Cigna Setting Facility Modifier None Typical Low $4.47 Median $6.92 Typical High $13.49 | Facility | None | $4.47 | $6.92 | $13.49 |
Cigna Setting Professional Modifier None Typical Low $3.02 Median $3.16 Typical High $3.80 | Professional | None | $3.02 | $3.16 | $3.80 |
Health Partners Setting Facility Modifier None Typical Low $3.98 Median $6.46 Typical High $11.22 | Facility | None | $3.98 | $6.46 | $11.22 |
Health Partners Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | None | $3.02 | $3.02 | $3.02 |
Medica Setting Facility Modifier None Typical Low $2.63 Median $2.63 Typical High $3.72 | Facility | None | $2.63 | $2.63 | $3.72 |
Medica Setting Professional Modifier None Typical Low $0.85 Median $1.12 Typical High $12.88 | Professional | None | $0.85 | $1.12 | $12.88 |
United Setting Professional Modifier None Typical Low $0.74 Median $1.10 Typical High $2.19 | Professional | None | $0.74 | $1.10 | $2.19 |
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 $0.98 Median $0.98 Typical High $0.98 | Facility | 52 · Reduced service | $0.98 | $0.98 | $0.98 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.39 Median $0.39 Typical High $0.39 | Facility | 53 · Discontinued | $0.39 | $0.39 | $0.39 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.28 Median $0.28 Typical High $0.28 | Facility | 55 · Aftercare only | $0.28 | $0.28 | $0.28 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.19 Median $0.19 Typical High $0.19 | Facility | 56 · Pre-op care only | $0.19 | $0.19 | $0.19 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.95 Median $0.98 Typical High $0.98 | Professional | 52 · Reduced service | $0.95 | $0.98 | $0.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.38 Median $0.39 Typical High $0.39 | Professional | 53 · Discontinued | $0.38 | $0.39 | $0.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | 55 · Aftercare only | $0.28 | $0.28 | $0.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.19 Median $0.19 Typical High $0.19 | Professional | 56 · Pre-op care only | $0.19 | $0.19 | $0.19 |
Where Minnesota sits
The same service costs 2.6 times more in Hawaii 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· 4th of 51
$2.63
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.