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 $0.76 Median $6.03 Typical High $9.77 | Facility | None | $0.76 | $6.03 | $9.77 |
Aetna Setting Professional Modifier None Typical Low $0.76 Median $0.76 Typical High $0.85 | Professional | None | $0.76 | $0.76 | $0.85 |
BCBS Minnesota Setting Facility Modifier None Typical Low $0.66 Median $1.38 Typical High $1.45 | Facility | None | $0.66 | $1.38 | $1.45 |
BCBS Minnesota Setting Professional Modifier None Typical Low $0.55 Median $0.62 Typical High $0.69 | Professional | None | $0.55 | $0.62 | $0.69 |
Cigna Setting Facility Modifier None Typical Low $0.91 Median $1.95 Typical High $2.69 | Facility | None | $0.91 | $1.95 | $2.69 |
Cigna Setting Professional Modifier None Typical Low $0.79 Median $0.83 Typical High $1.00 | Professional | None | $0.79 | $0.83 | $1.00 |
Health Partners Setting Facility Modifier None Typical Low $0.72 Median $1.78 Typical High $2.69 | Facility | None | $0.72 | $1.78 | $2.69 |
Health Partners Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | None | $0.79 | $0.79 | $0.79 |
Medica Setting Facility Modifier None Typical Low $0.72 Median $2.69 Typical High $8.71 | Facility | None | $0.72 | $2.69 | $8.71 |
Medica Setting Professional Modifier None Typical Low $0.89 Median $1.00 Typical High $1.62 | Professional | None | $0.89 | $1.00 | $1.62 |
United Setting Professional Modifier None Typical Low $0.69 Median $0.78 Typical High $1.29 | Professional | None | $0.69 | $0.78 | $1.29 |
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 $0.38 Median $0.38 Typical High $0.38 | Facility | 52 · Reduced service | $0.38 | $0.38 | $0.38 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.15 Median $0.15 Typical High $0.15 | Facility | 53 · Discontinued | $0.15 | $0.15 | $0.15 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.11 Median $0.11 Typical High $0.11 | Facility | 55 · Aftercare only | $0.11 | $0.11 | $0.11 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.08 Typical High $0.08 | Facility | 56 · Pre-op care only | $0.08 | $0.08 | $0.08 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.38 Median $0.38 Typical High $0.39 | Professional | 52 · Reduced service | $0.38 | $0.38 | $0.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.15 Median $0.15 Typical High $0.15 | Professional | 53 · Discontinued | $0.15 | $0.15 | $0.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.11 Median $0.11 Typical High $0.12 | Professional | 55 · Aftercare only | $0.11 | $0.11 | $0.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.08 Typical High $0.08 | Professional | 56 · Pre-op care only | $0.08 | $0.08 | $0.08 |
Where Minnesota sits
The same service costs 5.2 times more in Vermont than in Rhode Island. 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· 12th 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.