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 $0.55 Median $0.55 Typical High $0.55 | Facility | None | $0.55 | $0.55 | $0.55 |
Aetna Setting Professional Modifier None Typical Low $0.55 Median $0.55 Typical High $0.56 | Professional | None | $0.55 | $0.55 | $0.56 |
BCBS Minnesota Setting Facility Modifier None Typical Low $0.51 Median $0.71 Typical High $1.20 | Facility | None | $0.51 | $0.71 | $1.20 |
BCBS Minnesota Setting Professional Modifier None Typical Low $0.34 Median $0.42 Typical High $0.51 | Professional | None | $0.34 | $0.42 | $0.51 |
Cigna Setting Facility Modifier None Typical Low $0.78 Median $1.58 Typical High $2.14 | Facility | None | $0.78 | $1.58 | $2.14 |
Cigna Setting Professional Modifier None Typical Low $0.56 Median $0.62 Typical High $0.71 | Professional | None | $0.56 | $0.62 | $0.71 |
Health Partners Setting Facility Modifier None Typical Low $0.62 Median $1.48 Typical High $2.24 | Facility | None | $0.62 | $1.48 | $2.24 |
Health Partners Setting Professional Modifier None Typical Low $0.56 Median $0.56 Typical High $0.56 | Professional | None | $0.56 | $0.56 | $0.56 |
Medica Setting Facility Modifier None Typical Low $0.63 Median $0.66 Typical High $1.12 | Facility | None | $0.63 | $0.66 | $1.12 |
Medica Setting Professional Modifier None Typical Low $0.66 Median $0.66 Typical High $1.20 | Professional | None | $0.66 | $0.66 | $1.20 |
United Setting Professional Modifier None Typical Low $0.42 Median $0.42 Typical High $0.78 | Professional | None | $0.42 | $0.42 | $0.78 |
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 $0.28 Median $0.28 Typical High $0.28 | Facility | 52 · Reduced service | $0.28 | $0.28 | $0.28 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.11 Median $0.11 Typical High $0.11 | Facility | 53 · Discontinued | $0.11 | $0.11 | $0.11 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.08 Median $0.08 Typical High $0.08 | Facility | 55 · Aftercare only | $0.08 | $0.08 | $0.08 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.06 | Facility | 56 · Pre-op care only | $0.06 | $0.06 | $0.06 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | 52 · Reduced service | $0.28 | $0.28 | $0.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.11 Median $0.11 Typical High $0.11 | Professional | 53 · Discontinued | $0.11 | $0.11 | $0.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.08 Median $0.08 Typical High $0.08 | Professional | 55 · Aftercare only | $0.08 | $0.08 | $0.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.06 |
Where Minnesota sits
The same service costs 2.1 times more in Arizona than in Maryland. 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· 20th of 51
$0.56
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.