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 $1.00 Median $1.00 Typical High $1.00 | Facility | None | $1.00 | $1.00 | $1.00 |
Aetna Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.12 | Professional | None | $1.00 | $1.00 | $1.12 |
BCBS Minnesota Setting Facility Modifier None Typical Low $0.98 Median $1.95 Typical High $2.00 | Facility | None | $0.98 | $1.95 | $2.00 |
BCBS Minnesota Setting Professional Modifier None Typical Low $0.81 Median $0.91 Typical High $1.02 | Professional | None | $0.81 | $0.91 | $1.02 |
Cigna Setting Facility Modifier None Typical Low $1.32 Median $2.69 Typical High $3.63 | Facility | None | $1.32 | $2.69 | $3.63 |
Cigna Setting Professional Modifier None Typical Low $1.02 Median $1.12 Typical High $1.29 | Professional | None | $1.02 | $1.12 | $1.29 |
Health Partners Setting Facility Modifier None Typical Low $1.02 Median $2.51 Typical High $3.80 | Facility | None | $1.02 | $2.51 | $3.80 |
Health Partners Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | None | $1.00 | $1.00 | $1.00 |
Medica Setting Facility Modifier None Typical Low $1.00 Median $1.02 Typical High $1.66 | Facility | None | $1.00 | $1.02 | $1.66 |
Medica Setting Professional Modifier None Typical Low $1.00 Median $1.10 Typical High $1.82 | Professional | None | $1.00 | $1.10 | $1.82 |
United Setting Facility Modifier None Typical Low $1.00 Median $1.00 Typical High $1.00 | Facility | None | $1.00 | $1.00 | $1.00 |
United Setting Professional Modifier None Typical Low $1.02 Median $1.12 Typical High $1.91 | Professional | None | $1.02 | $1.12 | $1.91 |
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 $0.51 Median $0.51 Typical High $0.51 | Facility | 52 · Reduced service | $0.51 | $0.51 | $0.51 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.20 Median $0.20 Typical High $0.20 | Facility | 53 · Discontinued | $0.20 | $0.20 | $0.20 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.15 Median $0.15 Typical High $0.15 | Facility | 55 · Aftercare only | $0.15 | $0.15 | $0.15 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.10 Typical High $0.10 | Facility | 56 · Pre-op care only | $0.10 | $0.10 | $0.10 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.51 Median $0.51 Typical High $0.52 | Professional | 52 · Reduced service | $0.51 | $0.51 | $0.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.20 Median $0.20 Typical High $0.21 | Professional | 53 · Discontinued | $0.20 | $0.20 | $0.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.15 Median $0.15 Typical High $0.16 | Professional | 55 · Aftercare only | $0.15 | $0.15 | $0.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.10 Typical High $0.10 | Professional | 56 · Pre-op care only | $0.10 | $0.10 | $0.10 |
Where Minnesota sits
The same service costs 1.6 times more in Arizona than in New Jersey. 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
$1.02
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.