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 $0.21 Median $0.25 Typical High $0.25 | Professional | None | $0.21 | $0.25 | $0.25 |
BCBS Minnesota Setting Facility Modifier None Typical Low $0.36 Median $0.54 Typical High $0.72 | Facility | None | $0.36 | $0.54 | $0.72 |
BCBS Minnesota Setting Professional Modifier None Typical Low $0.28 Median $0.32 Typical High $0.36 | Professional | None | $0.28 | $0.32 | $0.36 |
Cigna Setting Professional Modifier None Typical Low $0.21 Median $0.21 Typical High $0.21 | Professional | None | $0.21 | $0.21 | $0.21 |
Medica Setting Facility Modifier None Typical Low $0.25 Median $0.34 Typical High $0.42 | Facility | None | $0.25 | $0.34 | $0.42 |
Medica Setting Professional Modifier None Typical Low $0.25 Median $0.25 Typical High $0.45 | Professional | None | $0.25 | $0.25 | $0.45 |
United Setting Professional Modifier None Typical Low $0.25 Median $0.25 Typical High $0.47 | Professional | None | $0.25 | $0.25 | $0.47 |
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 $0.13 Median $0.13 Typical High $0.13 | Facility | 52 · Reduced service | $0.13 | $0.13 | $0.13 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.05 Median $0.05 Typical High $0.05 | Facility | 53 · Discontinued | $0.05 | $0.05 | $0.05 |
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 Professional Modifier 52 · Reduced service Typical Low $0.11 Median $0.13 Typical High $0.13 | Professional | 52 · Reduced service | $0.11 | $0.13 | $0.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.04 Median $0.05 Typical High $0.05 | Professional | 53 · Discontinued | $0.04 | $0.05 | $0.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.03 Median $0.04 Typical High $0.04 | Professional | 55 · Aftercare only | $0.03 | $0.04 | $0.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.03 Typical High $0.03 | Professional | 56 · Pre-op care only | $0.02 | $0.03 | $0.03 |
Where Minnesota sits
The same service costs 1.6 times more in Alaska than in Washington. 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· 3rd of 51
$0.28
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.