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 $1.20 Median $1.20 Typical High $1.20 | Facility | None | $1.20 | $1.20 | $1.20 |
Aetna Setting Professional Modifier None Typical Low $0.95 Median $1.20 Typical High $1.20 | Professional | None | $0.95 | $1.20 | $1.20 |
BCBS Minnesota Setting Facility Modifier None Typical Low $12.88 Median $12.88 Typical High $12.88 | Facility | None | $12.88 | $12.88 | $12.88 |
BCBS Minnesota Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $12.59 | Professional | None | $11.22 | $11.22 | $12.59 |
Cigna Setting Facility Modifier None Typical Low $1.45 Median $2.95 Typical High $4.07 | Facility | None | $1.45 | $2.95 | $4.07 |
Cigna Setting Professional Modifier None Typical Low $1.12 Median $1.20 Typical High $1.45 | Professional | None | $1.12 | $1.20 | $1.45 |
Health Partners Setting Facility Modifier None Typical Low $1.15 Median $2.82 Typical High $4.27 | Facility | None | $1.15 | $2.82 | $4.27 |
Health Partners Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | None | $1.12 | $1.12 | $1.12 |
Medica Setting Facility Modifier None Typical Low $0.52 Median $1.62 Typical High $5.01 | Facility | None | $0.52 | $1.62 | $5.01 |
Medica Setting Professional Modifier None Typical Low $0.42 Median $1.05 Typical High $1.86 | Professional | None | $0.42 | $1.05 | $1.86 |
United Setting Professional Modifier None Typical Low $0.42 Median $1.05 Typical High $1.86 | Professional | None | $0.42 | $1.05 | $1.86 |
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 $0.60 Median $0.60 Typical High $0.60 | Facility | 52 · Reduced service | $0.60 | $0.60 | $0.60 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.24 Median $0.24 Typical High $0.24 | Facility | 53 · Discontinued | $0.24 | $0.24 | $0.24 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.18 Median $0.18 Typical High $0.18 | Facility | 55 · Aftercare only | $0.18 | $0.18 | $0.18 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.12 Median $0.12 Typical High $0.12 | Facility | 56 · Pre-op care only | $0.12 | $0.12 | $0.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.48 Median $0.60 Typical High $0.60 | Professional | 52 · Reduced service | $0.48 | $0.60 | $0.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.19 Median $0.24 Typical High $0.24 | Professional | 53 · Discontinued | $0.19 | $0.24 | $0.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.15 Median $0.18 Typical High $0.18 | Professional | 55 · Aftercare only | $0.15 | $0.18 | $0.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.12 Typical High $0.12 | Professional | 56 · Pre-op care only | $0.10 | $0.12 | $0.12 |
Where Minnesota sits
The same service costs 10.0 times more in Kansas than in Oklahoma. 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· 4th of 51
$1.20
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.