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 $16.60 Median $16.60 Typical High $16.60 | Facility | None | $16.60 | $16.60 | $16.60 |
Aetna Setting Professional Modifier None Typical Low $14.13 Median $16.60 Typical High $16.60 | Professional | None | $14.13 | $16.60 | $16.60 |
BCBS Minnesota Setting Facility Modifier None Typical Low $0.21 Median $0.41 Typical High $0.42 | Facility | None | $0.21 | $0.41 | $0.42 |
BCBS Minnesota Setting Professional Modifier None Typical Low $0.17 Median $0.19 Typical High $0.21 | Professional | None | $0.17 | $0.19 | $0.21 |
Cigna Setting Facility Modifier None Typical Low $13.18 Median $26.92 Typical High $36.31 | Facility | None | $13.18 | $26.92 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $10.23 Median $11.22 Typical High $12.88 | Professional | None | $10.23 | $11.22 | $12.88 |
Health Partners Setting Facility Modifier None Typical Low $10.23 Median $25.12 Typical High $38.02 | Facility | None | $10.23 | $25.12 | $38.02 |
Health Partners Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | None | $10.23 | $10.23 | $10.23 |
Medica Setting Facility Modifier None Typical Low $22.39 Median $28.18 Typical High $28.18 | Facility | None | $22.39 | $28.18 | $28.18 |
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 $8.32 Median $8.32 Typical High $8.32 | Facility | 52 · Reduced service | $8.32 | $8.32 | $8.32 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $3.31 Median $3.31 Typical High $3.31 | Facility | 53 · Discontinued | $3.31 | $3.31 | $3.31 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $2.51 Median $2.51 Typical High $2.51 | Facility | 55 · Aftercare only | $2.51 | $2.51 | $2.51 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.66 Median $1.66 Typical High $1.66 | Facility | 56 · Pre-op care only | $1.66 | $1.66 | $1.66 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $7.08 Median $8.32 Typical High $8.32 | Professional | 52 · Reduced service | $7.08 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $3.31 Typical High $3.31 | Professional | 53 · Discontinued | $2.82 | $3.31 | $3.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.14 Median $2.51 Typical High $2.51 | Professional | 55 · Aftercare only | $2.14 | $2.51 | $2.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.41 Median $1.66 Typical High $1.66 | Professional | 56 · Pre-op care only | $1.41 | $1.66 | $1.66 |
Where Minnesota sits
The same service costs 1412.5 times more in Wyoming than in Missouri. 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· 40th of 51
$10.23
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.