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 $0.49 Median $0.49 Typical High $0.49 | Facility | None | $0.49 | $0.49 | $0.49 |
Aetna Setting Professional Modifier None Typical Low $0.49 Median $0.49 Typical High $0.50 | Professional | None | $0.49 | $0.49 | $0.50 |
BCBS Minnesota Setting Facility Modifier None Typical Low $1.05 Median $1.26 Typical High $1.45 | Facility | None | $1.05 | $1.26 | $1.45 |
BCBS Minnesota Setting Professional Modifier None Typical Low $0.43 Median $0.54 Typical High $0.79 | Professional | None | $0.43 | $0.54 | $0.79 |
Cigna Setting Facility Modifier None Typical Low $0.83 Median $1.70 Typical High $2.29 | Facility | None | $0.83 | $1.70 | $2.29 |
Cigna Setting Professional Modifier None Typical Low $0.49 Median $0.50 Typical High $0.62 | Professional | None | $0.49 | $0.50 | $0.62 |
Health Partners Setting Facility Modifier None Typical Low $0.65 Median $1.58 Typical High $2.40 | Facility | None | $0.65 | $1.58 | $2.40 |
Health Partners Setting Professional Modifier None Typical Low $0.49 Median $0.49 Typical High $0.49 | Professional | None | $0.49 | $0.49 | $0.49 |
Medica Setting Facility Modifier None Typical Low $0.78 Median $1.23 Typical High $7.24 | Facility | None | $0.78 | $1.23 | $7.24 |
Medica Setting Professional Modifier None Typical Low $0.78 Median $0.87 Typical High $7.24 | Professional | None | $0.78 | $0.87 | $7.24 |
United Setting Facility Modifier None Typical Low $0.49 Median $0.49 Typical High $0.49 | Facility | None | $0.49 | $0.49 | $0.49 |
United Setting Professional Modifier None Typical Low $0.52 Median $0.55 Typical High $0.85 | Professional | None | $0.52 | $0.55 | $0.85 |
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 $0.25 Median $0.25 Typical High $0.25 | Facility | 52 · Reduced service | $0.25 | $0.25 | $0.25 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.10 Median $0.10 Typical High $0.10 | Facility | 53 · Discontinued | $0.10 | $0.10 | $0.10 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.07 Median $0.07 Typical High $0.07 | Facility | 55 · Aftercare only | $0.07 | $0.07 | $0.07 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.05 Typical High $0.05 | Facility | 56 · Pre-op care only | $0.05 | $0.05 | $0.05 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.25 Median $0.25 Typical High $0.25 | Professional | 52 · Reduced service | $0.25 | $0.25 | $0.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.10 Median $0.10 Typical High $0.10 | Professional | 53 · Discontinued | $0.10 | $0.10 | $0.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.07 Median $0.07 Typical High $0.08 | Professional | 55 · Aftercare only | $0.07 | $0.07 | $0.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.05 | $0.05 | $0.05 |
Where Minnesota sits
The same service costs 2.6 times more in Wyoming than in Illinois. 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· 28th of 51
$0.52
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.