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 $3.98 Median $3.98 Typical High $3.98 | Facility | None | $3.98 | $3.98 | $3.98 |
Aetna Setting Professional Modifier None Typical Low $3.89 Median $3.98 Typical High $4.27 | Professional | None | $3.89 | $3.98 | $4.27 |
BCBS Minnesota Setting Facility Modifier None Typical Low $4.90 Median $5.37 Typical High $8.91 | Facility | None | $4.90 | $5.37 | $8.91 |
BCBS Minnesota Setting Professional Modifier None Typical Low $4.37 Median $4.90 Typical High $5.50 | Professional | None | $4.37 | $4.90 | $5.50 |
Cigna Setting Facility Modifier None Typical Low $9.55 Median $15.14 Typical High $47.86 | Facility | None | $9.55 | $15.14 | $47.86 |
Cigna Setting Professional Modifier None Typical Low $6.46 Median $6.76 Typical High $8.13 | Professional | None | $6.46 | $6.76 | $8.13 |
Health Partners Setting Facility Modifier None Typical Low $8.51 Median $13.80 Typical High $25.12 | Facility | None | $8.51 | $13.80 | $25.12 |
Health Partners Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | None | $6.31 | $6.31 | $6.31 |
Medica Setting Facility Modifier None Typical Low $5.37 Median $5.37 Typical High $10.00 | Facility | None | $5.37 | $5.37 | $10.00 |
Medica Setting Professional Modifier None Typical Low $1.74 Median $2.29 Typical High $83.18 | Professional | None | $1.74 | $2.29 | $83.18 |
United Setting Professional Modifier None Typical Low $1.51 Median $2.24 Typical High $4.47 | Professional | None | $1.51 | $2.24 | $4.47 |
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 $2.00 Median $2.00 Typical High $2.00 | Facility | 52 · Reduced service | $2.00 | $2.00 | $2.00 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.79 Median $0.79 Typical High $0.79 | Facility | 53 · Discontinued | $0.79 | $0.79 | $0.79 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $3.02 Median $3.02 Typical High $3.02 | Facility | 54 · Surgery only | $3.02 | $3.02 | $3.02 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.60 Median $0.60 Typical High $0.60 | Facility | 55 · Aftercare only | $0.60 | $0.60 | $0.60 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.40 Median $0.40 Typical High $0.40 | Facility | 56 · Pre-op care only | $0.40 | $0.40 | $0.40 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.95 Median $2.00 Typical High $2.00 | Professional | 52 · Reduced service | $1.95 | $2.00 | $2.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.78 Median $0.79 Typical High $0.79 | Professional | 53 · Discontinued | $0.78 | $0.79 | $0.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2.95 Median $3.02 Typical High $3.02 | Professional | 54 · Surgery only | $2.95 | $3.02 | $3.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.59 Median $0.60 Typical High $0.60 | Professional | 55 · Aftercare only | $0.59 | $0.60 | $0.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.39 Median $0.40 Typical High $0.40 | Professional | 56 · Pre-op care only | $0.39 | $0.40 | $0.40 |
Where Minnesota sits
The same service costs 3.8 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
$5.50
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.