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 $15.85 Median $15.85 Typical High $15.85 | Facility | None | $15.85 | $15.85 | $15.85 |
Aetna Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $19.05 | Professional | None | $15.85 | $15.85 | $19.05 |
BCBS Minnesota Setting Facility Modifier None Typical Low $16.98 Median $19.05 Typical High $28.84 | Facility | None | $16.98 | $19.05 | $28.84 |
BCBS Minnesota Setting Professional Modifier None Typical Low $15.49 Median $19.05 Typical High $19.05 | Professional | None | $15.49 | $19.05 | $19.05 |
Cigna Setting Facility Modifier None Typical Low $14.45 Median $63.10 Typical High $162.18 | Facility | None | $14.45 | $63.10 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $22.91 Typical High $27.54 | Professional | None | $21.88 | $22.91 | $27.54 |
Health Partners Setting Facility Modifier None Typical Low $40.74 Median $64.57 Typical High $154.88 | Facility | None | $40.74 | $64.57 | $154.88 |
Health Partners Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
Medica Setting Facility Modifier None Typical Low $8.13 Median $19.05 Typical High $102.33 | Facility | None | $8.13 | $19.05 | $102.33 |
Medica Setting Professional Modifier None Typical Low $7.59 Median $14.13 Typical High $125.89 | Professional | None | $7.59 | $14.13 | $125.89 |
United Setting Facility Modifier None Typical Low $12.59 Median $12.88 Typical High $25.70 | Facility | None | $12.59 | $12.88 | $25.70 |
United Setting Professional Modifier None Typical Low $6.31 Median $10.96 Typical High $19.05 | Professional | None | $6.31 | $10.96 | $19.05 |
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 $7.94 Median $7.94 Typical High $7.94 | Facility | 52 · Reduced service | $7.94 | $7.94 | $7.94 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $3.16 Median $3.16 Typical High $3.16 | Facility | 53 · Discontinued | $3.16 | $3.16 | $3.16 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $2.40 Median $2.40 Typical High $2.40 | Facility | 55 · Aftercare only | $2.40 | $2.40 | $2.40 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.58 Median $1.58 Typical High $1.58 | Facility | 56 · Pre-op care only | $1.58 | $1.58 | $1.58 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | 52 · Reduced service | $7.94 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | 53 · Discontinued | $3.16 | $3.16 | $3.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.40 Median $2.40 Typical High $2.40 | Professional | 55 · Aftercare only | $2.40 | $2.40 | $2.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.58 Median $1.58 Typical High $1.58 | Professional | 56 · Pre-op care only | $1.58 | $1.58 | $1.58 |
Where Minnesota sits
The same service costs 3.0 times more in Hawaii than in Delaware. 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· 8th of 51
$19.05
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.