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 $0.15 Median $3.63 Typical High $30.20 | Facility | None | $0.15 | $3.63 | $30.20 |
Aetna Setting Professional Modifier None Typical Low $0.12 Median $0.15 Typical High $0.15 | Professional | None | $0.12 | $0.15 | $0.15 |
BCBS Minnesota Setting Facility Modifier None Typical Low $0.28 Median $0.59 Typical High $0.62 | Facility | None | $0.28 | $0.59 | $0.62 |
BCBS Minnesota Setting Professional Modifier None Typical Low $0.25 Median $0.31 Typical High $0.31 | Professional | None | $0.25 | $0.31 | $0.31 |
Cigna Setting Facility Modifier None Typical Low $0.78 Median $1.20 Typical High $3.39 | Facility | None | $0.78 | $1.20 | $3.39 |
Cigna Setting Professional Modifier None Typical Low $0.38 Median $0.38 Typical High $0.48 | Professional | None | $0.38 | $0.38 | $0.48 |
Health Partners Setting Facility Modifier None Typical Low $0.71 Median $1.12 Typical High $2.63 | Facility | None | $0.71 | $1.12 | $2.63 |
Health Partners Setting Professional Modifier None Typical Low $0.38 Median $0.38 Typical High $0.38 | Professional | None | $0.38 | $0.38 | $0.38 |
Medica Setting Facility Modifier None Typical Low $0.20 Median $3.55 Typical High $6.76 | Facility | None | $0.20 | $3.55 | $6.76 |
Medica Setting Professional Modifier None Typical Low $0.10 Median $0.10 Typical High $61.66 | Professional | None | $0.10 | $0.10 | $61.66 |
United Setting Professional Modifier None Typical Low $0.13 Median $0.13 Typical High $0.19 | Professional | None | $0.13 | $0.13 | $0.19 |
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 $0.08 Median $0.08 Typical High $0.08 | Facility | 52 · Reduced service | $0.08 | $0.08 | $0.08 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.03 Median $0.03 Typical High $0.03 | Facility | 53 · Discontinued | $0.03 | $0.03 | $0.03 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.02 Median $0.02 Typical High $0.02 | Facility | 55 · Aftercare only | $0.02 | $0.02 | $0.02 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $0.02 | Facility | 56 · Pre-op care only | $0.02 | $0.02 | $0.02 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.06 Median $0.08 Typical High $0.08 | Professional | 52 · Reduced service | $0.06 | $0.08 | $0.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.02 Median $0.03 Typical High $0.03 | Professional | 53 · Discontinued | $0.02 | $0.03 | $0.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $0.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $0.02 |
Where Minnesota sits
The same service costs 32.4 times more in Montana than in Hawaii. 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· 2nd of 51
$0.38
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.