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 $8.71 Median $8.71 Typical High $8.71 | Facility | None | $8.71 | $8.71 | $8.71 |
Aetna Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $8.91 | Professional | None | $8.71 | $8.71 | $8.91 |
BCBS Minnesota Setting Facility Modifier None Typical Low $6.46 Median $12.59 Typical High $15.85 | Facility | None | $6.46 | $12.59 | $15.85 |
BCBS Minnesota Setting Professional Modifier None Typical Low $7.24 Median $8.51 Typical High $9.12 | Professional | None | $7.24 | $8.51 | $9.12 |
Cigna Setting Facility Modifier None Typical Low $10.00 Median $12.02 Typical High $22.91 | Facility | None | $10.00 | $12.02 | $22.91 |
Cigna Setting Professional Modifier None Typical Low $8.71 Median $8.91 Typical High $11.22 | Professional | None | $8.71 | $8.91 | $11.22 |
Health Partners Setting Facility Modifier None Typical Low $9.55 Median $10.96 Typical High $27.54 | Facility | None | $9.55 | $10.96 | $27.54 |
Health Partners Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | None | $8.71 | $8.71 | $8.71 |
Medica Setting Facility Modifier None Typical Low $7.94 Median $9.77 Typical High $13.49 | Facility | None | $7.94 | $9.77 | $13.49 |
Medica Setting Professional Modifier None Typical Low $7.94 Median $8.51 Typical High $14.45 | Professional | None | $7.94 | $8.51 | $14.45 |
United Setting Facility Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Facility | None | $8.71 | $8.71 | $8.71 |
United Setting Professional Modifier None Typical Low $8.71 Median $9.12 Typical High $14.13 | Professional | None | $8.71 | $9.12 | $14.13 |
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 $4.37 Median $4.37 Typical High $4.37 | Facility | 52 · Reduced service | $4.37 | $4.37 | $4.37 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.74 Median $1.74 Typical High $1.74 | Facility | 53 · Discontinued | $1.74 | $1.74 | $1.74 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $1.29 Median $1.29 Typical High $1.29 | Facility | 55 · Aftercare only | $1.29 | $1.29 | $1.29 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.87 Median $0.87 Typical High $0.87 | Facility | 56 · Pre-op care only | $0.87 | $0.87 | $0.87 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $4.37 Median $4.37 Typical High $4.47 | Professional | 52 · Reduced service | $4.37 | $4.37 | $4.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.74 Median $1.74 Typical High $1.78 | Professional | 53 · Discontinued | $1.74 | $1.74 | $1.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.29 Median $1.29 Typical High $1.35 | Professional | 55 · Aftercare only | $1.29 | $1.29 | $1.35 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.87 Median $0.87 Typical High $0.89 | Professional | 56 · Pre-op care only | $0.87 | $0.87 | $0.89 |
Where Minnesota sits
The same service costs 1.9 times more in Wyoming than in Mississippi. 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· 15th of 51
$8.91
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.