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 $0.91 Median $0.91 Typical High $0.91 | Facility | None | $0.91 | $0.91 | $0.91 |
Aetna Setting Professional Modifier None Typical Low $0.76 Median $0.91 Typical High $0.91 | Professional | None | $0.76 | $0.91 | $0.91 |
BCBS Minnesota Setting Facility Modifier None Typical Low $0.87 Median $1.32 Typical High $1.78 | Facility | None | $0.87 | $1.32 | $1.78 |
BCBS Minnesota Setting Professional Modifier None Typical Low $0.71 Median $0.79 Typical High $0.87 | Professional | None | $0.71 | $0.79 | $0.87 |
Cigna Setting Facility Modifier None Typical Low $0.98 Median $2.00 Typical High $2.69 | Facility | None | $0.98 | $2.00 | $2.69 |
Cigna Setting Professional Modifier None Typical Low $0.76 Median $0.83 Typical High $0.95 | Professional | None | $0.76 | $0.83 | $0.95 |
Health Partners Setting Facility Modifier None Typical Low $0.76 Median $1.86 Typical High $2.82 | Facility | None | $0.76 | $1.86 | $2.82 |
Health Partners Setting Professional Modifier None Typical Low $0.76 Median $0.76 Typical High $0.76 | Professional | None | $0.76 | $0.76 | $0.76 |
Medica Setting Facility Modifier None Typical Low $0.48 Median $0.62 Typical High $1.55 | Facility | None | $0.48 | $0.62 | $1.55 |
Medica Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $1.45 | Professional | None | $0.79 | $0.79 | $1.45 |
United Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $1.48 | Professional | None | $0.79 | $0.79 | $1.48 |
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 $0.46 Median $0.46 Typical High $0.46 | Facility | 52 · Reduced service | $0.46 | $0.46 | $0.46 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.18 Median $0.18 Typical High $0.18 | Facility | 53 · Discontinued | $0.18 | $0.18 | $0.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.14 Median $0.14 Typical High $0.14 | Facility | 55 · Aftercare only | $0.14 | $0.14 | $0.14 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.09 Median $0.09 Typical High $0.09 | Facility | 56 · Pre-op care only | $0.09 | $0.09 | $0.09 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.39 Median $0.46 Typical High $0.46 | Professional | 52 · Reduced service | $0.39 | $0.46 | $0.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.16 Median $0.18 Typical High $0.18 | Professional | 53 · Discontinued | $0.16 | $0.18 | $0.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.12 Median $0.14 Typical High $0.14 | Professional | 55 · Aftercare only | $0.12 | $0.14 | $0.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.09 Typical High $0.09 | Professional | 56 · Pre-op care only | $0.08 | $0.09 | $0.09 |
Where Minnesota sits
The same service costs 14.5 times more in Kansas than in Montana. 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
$0.87
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.