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 $12.02 Median $12.02 Typical High $12.02 | Facility | None | $12.02 | $12.02 | $12.02 |
Aetna Setting Professional Modifier None Typical Low $11.75 Median $12.02 Typical High $12.02 | Professional | None | $11.75 | $12.02 | $12.02 |
BCBS Minnesota Setting Facility Modifier None Typical Low $14.79 Median $16.22 Typical High $26.30 | Facility | None | $14.79 | $16.22 | $26.30 |
BCBS Minnesota Setting Professional Modifier None Typical Low $13.18 Median $14.79 Typical High $16.60 | Professional | None | $13.18 | $14.79 | $16.60 |
Cigna Setting Facility Modifier None Typical Low $28.18 Median $44.67 Typical High $141.25 | Facility | None | $28.18 | $44.67 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $19.05 Median $19.95 Typical High $23.99 | Professional | None | $19.05 | $19.95 | $23.99 |
Health Partners Setting Facility Modifier None Typical Low $25.12 Median $40.74 Typical High $74.13 | Facility | None | $25.12 | $40.74 | $74.13 |
Health Partners Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | None | $18.62 | $18.62 | $18.62 |
Medica Setting Facility Modifier None Typical Low $16.22 Median $16.22 Typical High $26.30 | Facility | None | $16.22 | $16.22 | $26.30 |
Medica Setting Professional Modifier None Typical Low $5.25 Median $6.92 Typical High $218.78 | Professional | None | $5.25 | $6.92 | $218.78 |
United Setting Professional Modifier None Typical Low $4.57 Median $6.76 Typical High $13.49 | Professional | None | $4.57 | $6.76 | $13.49 |
10 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 $6.03 Median $6.03 Typical High $6.03 | Facility | 52 · Reduced service | $6.03 | $6.03 | $6.03 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.40 Median $2.40 Typical High $2.40 | Facility | 53 · Discontinued | $2.40 | $2.40 | $2.40 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $8.91 Median $8.91 Typical High $8.91 | Facility | 54 · Surgery only | $8.91 | $8.91 | $8.91 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $1.82 Median $1.82 Typical High $1.82 | Facility | 55 · Aftercare only | $1.82 | $1.82 | $1.82 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.20 Median $1.20 Typical High $1.20 | Facility | 56 · Pre-op care only | $1.20 | $1.20 | $1.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $5.89 Median $6.03 Typical High $6.03 | Professional | 52 · Reduced service | $5.89 | $6.03 | $6.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.34 Median $2.40 Typical High $2.40 | Professional | 53 · Discontinued | $2.34 | $2.40 | $2.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | 54 · Surgery only | $8.91 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.78 Median $1.82 Typical High $1.82 | Professional | 55 · Aftercare only | $1.78 | $1.82 | $1.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.17 Median $1.20 Typical High $1.20 | Professional | 56 · Pre-op care only | $1.17 | $1.20 | $1.20 |
Where Minnesota sits
The same service costs 3.2 times more in Rhode Island than in New York. 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· 6th of 51
$16.60
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.