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 $1.35 Median $1.35 Typical High $4.27 | Facility | None | $1.35 | $1.35 | $4.27 |
Aetna Setting Professional Modifier None Typical Low $1.35 Median $1.35 Typical High $1.48 | Professional | None | $1.35 | $1.35 | $1.48 |
BCBS Minnesota Setting Facility Modifier None Typical Low $1.23 Median $2.51 Typical High $2.57 | Facility | None | $1.23 | $2.51 | $2.57 |
BCBS Minnesota Setting Professional Modifier None Typical Low $1.07 Median $1.23 Typical High $1.35 | Professional | None | $1.07 | $1.23 | $1.35 |
Cigna Setting Facility Modifier None Typical Low $1.70 Median $3.63 Typical High $4.79 | Facility | None | $1.70 | $3.63 | $4.79 |
Cigna Setting Professional Modifier None Typical Low $1.41 Median $1.51 Typical High $1.78 | Professional | None | $1.41 | $1.51 | $1.78 |
Health Partners Setting Facility Modifier None Typical Low $1.35 Median $3.31 Typical High $4.90 | Facility | None | $1.35 | $3.31 | $4.90 |
Health Partners Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $1.38 | Professional | None | $1.38 | $1.38 | $1.38 |
Medica Setting Facility Modifier None Typical Low $1.10 Median $7.94 Typical High $13.18 | Facility | None | $1.10 | $7.94 | $13.18 |
Medica Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $2.51 | Professional | None | $1.38 | $1.38 | $2.51 |
United Setting Professional Modifier None Typical Low $1.35 Median $1.35 Typical High $2.51 | Professional | None | $1.35 | $1.35 | $2.51 |
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 $0.68 Median $0.68 Typical High $0.68 | Facility | 52 · Reduced service | $0.68 | $0.68 | $0.68 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.27 Median $0.27 Typical High $0.27 | Facility | 53 · Discontinued | $0.27 | $0.27 | $0.27 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.20 Median $0.20 Typical High $0.20 | Facility | 55 · Aftercare only | $0.20 | $0.20 | $0.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.14 Typical High $0.14 | Facility | 56 · Pre-op care only | $0.14 | $0.14 | $0.14 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.68 Median $0.68 Typical High $0.71 | Professional | 52 · Reduced service | $0.68 | $0.68 | $0.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.27 Median $0.27 Typical High $0.28 | Professional | 53 · Discontinued | $0.27 | $0.27 | $0.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.20 Median $0.20 Typical High $0.21 | Professional | 55 · Aftercare only | $0.20 | $0.20 | $0.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.14 Typical High $0.14 | Professional | 56 · Pre-op care only | $0.14 | $0.14 | $0.14 |
Where Minnesota sits
The same service costs 3.2 times more in Wyoming than in Maine. 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· 27th of 51
$1.38
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.