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 $4.17 Median $4.17 Typical High $4.17 | Facility | None | $4.17 | $4.17 | $4.17 |
Aetna Setting Professional Modifier None Typical Low $4.17 Median $4.17 Typical High $4.17 | Professional | None | $4.17 | $4.17 | $4.17 |
BCBS Minnesota Setting Facility Modifier None Typical Low $5.13 Median $5.75 Typical High $9.33 | Facility | None | $5.13 | $5.75 | $9.33 |
BCBS Minnesota Setting Professional Modifier None Typical Low $4.68 Median $5.75 Typical High $5.75 | Professional | None | $4.68 | $5.75 | $5.75 |
Cigna Setting Facility Modifier None Typical Low $10.23 Median $16.22 Typical High $51.29 | Facility | None | $10.23 | $16.22 | $51.29 |
Cigna Setting Professional Modifier None Typical Low $6.76 Median $7.08 Typical High $8.51 | Professional | None | $6.76 | $7.08 | $8.51 |
Health Partners Setting Facility Modifier None Typical Low $8.91 Median $14.45 Typical High $26.30 | Facility | None | $8.91 | $14.45 | $26.30 |
Health Partners Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | None | $6.76 | $6.76 | $6.76 |
Medica Setting Facility Modifier None Typical Low $5.75 Median $5.75 Typical High $8.32 | Facility | None | $5.75 | $5.75 | $8.32 |
Medica Setting Professional Modifier None Typical Low $1.91 Median $2.40 Typical High $69.18 | Professional | None | $1.91 | $2.40 | $69.18 |
United Setting Professional Modifier None Typical Low $1.62 Median $2.34 Typical High $4.79 | Professional | None | $1.62 | $2.34 | $4.79 |
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 $2.09 Median $2.09 Typical High $2.09 | Facility | 52 · Reduced service | $2.09 | $2.09 | $2.09 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.83 Median $0.83 Typical High $0.83 | Facility | 53 · Discontinued | $0.83 | $0.83 | $0.83 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $3.16 Median $3.16 Typical High $3.16 | Facility | 54 · Surgery only | $3.16 | $3.16 | $3.16 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.63 Median $0.63 Typical High $0.63 | Facility | 55 · Aftercare only | $0.63 | $0.63 | $0.63 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.42 Median $0.42 Typical High $0.42 | Facility | 56 · Pre-op care only | $0.42 | $0.42 | $0.42 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.09 Median $2.09 Typical High $2.09 | Professional | 52 · Reduced service | $2.09 | $2.09 | $2.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.83 Median $0.83 Typical High $0.83 | Professional | 53 · Discontinued | $0.83 | $0.83 | $0.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3.09 Median $3.16 Typical High $3.16 | Professional | 54 · Surgery only | $3.09 | $3.16 | $3.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.62 Median $0.63 Typical High $0.63 | Professional | 55 · Aftercare only | $0.62 | $0.63 | $0.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.42 Median $0.42 Typical High $0.42 | Professional | 56 · Pre-op care only | $0.42 | $0.42 | $0.42 |
Where Minnesota sits
The same service costs 3.0 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· 7th of 51
$5.75
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.