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 $6.03 Median $6.03 Typical High $6.03 | Facility | None | $6.03 | $6.03 | $6.03 |
Aetna Setting Professional Modifier None Typical Low $5.89 Median $6.03 Typical High $6.46 | Professional | None | $5.89 | $6.03 | $6.46 |
BCBS Minnesota Setting Facility Modifier None Typical Low $7.24 Median $8.13 Typical High $13.18 | Facility | None | $7.24 | $8.13 | $13.18 |
BCBS Minnesota Setting Professional Modifier None Typical Low $6.61 Median $7.41 Typical High $8.32 | Professional | None | $6.61 | $7.41 | $8.32 |
Cigna Setting Facility Modifier None Typical Low $14.13 Median $22.39 Typical High $70.79 | Facility | None | $14.13 | $22.39 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $9.55 Median $10.00 Typical High $12.02 | Professional | None | $9.55 | $10.00 | $12.02 |
Health Partners Setting Facility Modifier None Typical Low $12.59 Median $19.95 Typical High $37.15 | Facility | None | $12.59 | $19.95 | $37.15 |
Health Partners Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | None | $9.33 | $9.33 | $9.33 |
Medica Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $13.18 | Facility | None | $8.13 | $8.13 | $13.18 |
Medica Setting Professional Modifier None Typical Low $2.63 Median $3.47 Typical High $107.15 | Professional | None | $2.63 | $3.47 | $107.15 |
United Setting Professional Modifier None Typical Low $2.29 Median $3.39 Typical High $6.76 | Professional | None | $2.29 | $3.39 | $6.76 |
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 $3.02 Median $3.02 Typical High $3.02 | Facility | 52 · Reduced service | $3.02 | $3.02 | $3.02 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.20 Median $1.20 Typical High $1.20 | Facility | 53 · Discontinued | $1.20 | $1.20 | $1.20 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $4.47 Median $4.47 Typical High $4.47 | Facility | 54 · Surgery only | $4.47 | $4.47 | $4.47 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.89 Median $0.89 Typical High $0.89 | Facility | 55 · Aftercare only | $0.89 | $0.89 | $0.89 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.60 Median $0.60 Typical High $0.60 | Facility | 56 · Pre-op care only | $0.60 | $0.60 | $0.60 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.95 Median $3.02 Typical High $3.02 | Professional | 52 · Reduced service | $2.95 | $3.02 | $3.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.17 Median $1.20 Typical High $1.20 | Professional | 53 · Discontinued | $1.17 | $1.20 | $1.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | 54 · Surgery only | $4.47 | $4.47 | $4.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.87 Median $0.89 Typical High $0.89 | Professional | 55 · Aftercare only | $0.87 | $0.89 | $0.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.59 Median $0.60 Typical High $0.60 | Professional | 56 · Pre-op care only | $0.59 | $0.60 | $0.60 |
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· 5th of 51
$8.32
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.