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 $3.02 Median $3.02 Typical High $3.02 | Facility | None | $3.02 | $3.02 | $3.02 |
Aetna Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.39 | Professional | None | $3.02 | $3.02 | $3.39 |
BCBS Minnesota Setting Facility Modifier None Typical Low $6.31 Median $9.12 Typical High $9.33 | Facility | None | $6.31 | $9.12 | $9.33 |
BCBS Minnesota Setting Professional Modifier None Typical Low $2.63 Median $3.24 Typical High $5.37 | Professional | None | $2.63 | $3.24 | $5.37 |
Cigna Setting Facility Modifier None Typical Low $4.79 Median $9.77 Typical High $13.18 | Facility | None | $4.79 | $9.77 | $13.18 |
Cigna Setting Professional Modifier None Typical Low $3.09 Median $3.39 Typical High $3.89 | Professional | None | $3.09 | $3.39 | $3.89 |
Health Partners Setting Facility Modifier None Typical Low $3.72 Median $9.12 Typical High $13.80 | Facility | None | $3.72 | $9.12 | $13.80 |
Health Partners Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $3.09 | Professional | None | $3.09 | $3.09 | $3.09 |
Medica Setting Facility Modifier None Typical Low $5.50 Median $5.50 Typical High $10.47 | Facility | None | $5.50 | $5.50 | $10.47 |
Medica Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $9.77 | Professional | None | $5.50 | $5.50 | $9.77 |
United Setting Facility Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Facility | None | $3.02 | $3.02 | $3.02 |
United Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $6.17 | Professional | None | $3.24 | $3.24 | $6.17 |
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 $1.51 Median $1.51 Typical High $1.51 | Facility | 52 · Reduced service | $1.51 | $1.51 | $1.51 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.62 Median $0.62 Typical High $0.62 | Facility | 53 · Discontinued | $0.62 | $0.62 | $0.62 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.46 Median $0.46 Typical High $0.46 | Facility | 55 · Aftercare only | $0.46 | $0.46 | $0.46 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.30 Typical High $0.30 | Facility | 56 · Pre-op care only | $0.30 | $0.30 | $0.30 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.51 Median $1.51 Typical High $1.58 | Professional | 52 · Reduced service | $1.51 | $1.51 | $1.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.62 Median $0.62 Typical High $0.63 | Professional | 53 · Discontinued | $0.62 | $0.62 | $0.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.46 Median $0.46 Typical High $0.47 | Professional | 55 · Aftercare only | $0.46 | $0.46 | $0.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.30 Typical High $0.31 | Professional | 56 · Pre-op care only | $0.30 | $0.30 | $0.31 |
Where Minnesota sits
The same service costs 6.0 times more in Wyoming than in Georgia. 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· 43rd of 51
$3.24
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.