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 $0.65 Median $0.65 Typical High $0.65 | Facility | None | $0.65 | $0.65 | $0.65 |
Aetna Setting Professional Modifier None Typical Low $0.63 Median $0.65 Typical High $0.65 | Professional | None | $0.63 | $0.65 | $0.65 |
BCBS Minnesota Setting Facility Modifier None Typical Low $0.78 Median $1.05 Typical High $1.62 | Facility | None | $0.78 | $1.05 | $1.62 |
BCBS Minnesota Setting Professional Modifier None Typical Low $0.72 Median $0.87 Typical High $0.89 | Professional | None | $0.72 | $0.87 | $0.89 |
Cigna Setting Facility Modifier None Typical Low $1.70 Median $2.63 Typical High $5.01 | Facility | None | $1.70 | $2.63 | $5.01 |
Cigna Setting Professional Modifier None Typical Low $1.12 Median $1.20 Typical High $1.45 | Professional | None | $1.12 | $1.20 | $1.45 |
Health Partners Setting Facility Modifier None Typical Low $1.51 Median $2.40 Typical High $4.27 | Facility | None | $1.51 | $2.40 | $4.27 |
Health Partners Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | None | $1.12 | $1.12 | $1.12 |
Medica Setting Facility Modifier None Typical Low $0.87 Median $0.87 Typical High $1.26 | Facility | None | $0.87 | $0.87 | $1.26 |
Medica Setting Professional Modifier None Typical Low $0.28 Median $0.37 Typical High $4.37 | Professional | None | $0.28 | $0.37 | $4.37 |
United Setting Professional Modifier None Typical Low $0.25 Median $0.37 Typical High $0.72 | Professional | None | $0.25 | $0.37 | $0.72 |
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 $0.33 Median $0.33 Typical High $0.33 | Facility | 52 · Reduced service | $0.33 | $0.33 | $0.33 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.13 Median $0.13 Typical High $0.13 | Facility | 53 · Discontinued | $0.13 | $0.13 | $0.13 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.10 Median $0.10 Typical High $0.10 | Facility | 55 · Aftercare only | $0.10 | $0.10 | $0.10 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.07 Median $0.07 Typical High $0.07 | Facility | 56 · Pre-op care only | $0.07 | $0.07 | $0.07 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.32 Median $0.33 Typical High $0.33 | Professional | 52 · Reduced service | $0.32 | $0.33 | $0.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | 53 · Discontinued | $0.13 | $0.13 | $0.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.10 Median $0.10 Typical High $0.10 | Professional | 55 · Aftercare only | $0.10 | $0.10 | $0.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.07 Typical High $0.07 | Professional | 56 · Pre-op care only | $0.06 | $0.07 | $0.07 |
Where Minnesota sits
The same service costs 2.6 times more in Hawaii than in Utah. 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
$0.89
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.