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 $3.55 Median $3.55 Typical High $3.55 | Facility | None | $3.55 | $3.55 | $3.55 |
Aetna Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.63 | Professional | None | $3.55 | $3.55 | $3.63 |
BCBS Minnesota Setting Facility Modifier None Typical Low $5.13 Median $6.76 Typical High $10.00 | Facility | None | $5.13 | $6.76 | $10.00 |
BCBS Minnesota Setting Professional Modifier None Typical Low $2.75 Median $3.39 Typical High $4.37 | Professional | None | $2.75 | $3.39 | $4.37 |
Cigna Setting Facility Modifier None Typical Low $4.47 Median $9.33 Typical High $12.59 | Facility | None | $4.47 | $9.33 | $12.59 |
Cigna Setting Professional Modifier None Typical Low $3.63 Median $3.98 Typical High $4.57 | Professional | None | $3.63 | $3.98 | $4.57 |
Health Partners Setting Facility Modifier None Typical Low $3.55 Median $8.71 Typical High $13.18 | Facility | None | $3.55 | $8.71 | $13.18 |
Health Partners Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | None | $3.63 | $3.63 | $3.63 |
Medica Setting Facility Modifier None Typical Low $3.55 Median $5.75 Typical High $19.50 | Facility | None | $3.55 | $5.75 | $19.50 |
Medica Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $7.08 | Professional | None | $3.89 | $3.89 | $7.08 |
United Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $6.31 | Professional | None | $3.39 | $3.39 | $6.31 |
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 $1.78 Median $1.78 Typical High $1.78 | Facility | 52 · Reduced service | $1.78 | $1.78 | $1.78 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.71 Median $0.71 Typical High $0.71 | Facility | 53 · Discontinued | $0.71 | $0.71 | $0.71 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.52 Median $0.52 Typical High $0.52 | Facility | 55 · Aftercare only | $0.52 | $0.52 | $0.52 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.36 Typical High $0.36 | Facility | 56 · Pre-op care only | $0.36 | $0.36 | $0.36 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.78 Median $1.78 Typical High $1.82 | Professional | 52 · Reduced service | $1.78 | $1.78 | $1.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.71 Median $0.71 Typical High $0.72 | Professional | 53 · Discontinued | $0.71 | $0.71 | $0.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.52 Typical High $0.55 | Professional | 55 · Aftercare only | $0.52 | $0.52 | $0.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.36 Typical High $0.37 | Professional | 56 · Pre-op care only | $0.36 | $0.36 | $0.37 |
Where Minnesota sits
The same service costs 4.0 times more in Oklahoma 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· 37th of 51
$3.63
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.