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 $6.17 Median $6.17 Typical High $6.17 | Facility | None | $6.17 | $6.17 | $6.17 |
Aetna Setting Professional Modifier None Typical Low $6.17 Median $6.17 Typical High $8.51 | Professional | None | $6.17 | $6.17 | $8.51 |
BCBS Minnesota Setting Facility Modifier None Typical Low $7.59 Median $8.51 Typical High $13.80 | Facility | None | $7.59 | $8.51 | $13.80 |
BCBS Minnesota Setting Professional Modifier None Typical Low $6.92 Median $8.51 Typical High $8.51 | Professional | None | $6.92 | $8.51 | $8.51 |
Cigna Setting Facility Modifier None Typical Low $14.79 Median $23.44 Typical High $74.13 | Facility | None | $14.79 | $23.44 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $10.23 Typical High $12.30 | Professional | None | $9.77 | $10.23 | $12.30 |
Health Partners Setting Facility Modifier None Typical Low $12.88 Median $20.89 Typical High $38.02 | Facility | None | $12.88 | $20.89 | $38.02 |
Health Partners Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
Medica Setting Facility Modifier None Typical Low $8.51 Median $8.51 Typical High $16.60 | Facility | None | $8.51 | $8.51 | $16.60 |
Medica Setting Professional Modifier None Typical Low $2.82 Median $3.55 Typical High $138.04 | Professional | None | $2.82 | $3.55 | $138.04 |
United Setting Professional Modifier None Typical Low $2.40 Median $3.47 Typical High $7.08 | Professional | None | $2.40 | $3.47 | $7.08 |
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 $3.09 Median $3.09 Typical High $3.09 | Facility | 52 · Reduced service | $3.09 | $3.09 | $3.09 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.26 Median $1.26 Typical High $1.26 | Facility | 53 · Discontinued | $1.26 | $1.26 | $1.26 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $4.68 Median $4.68 Typical High $4.68 | Facility | 54 · Surgery only | $4.68 | $4.68 | $4.68 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.93 Median $0.93 Typical High $0.93 | Facility | 55 · Aftercare only | $0.93 | $0.93 | $0.93 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.62 Median $0.62 Typical High $0.62 | Facility | 56 · Pre-op care only | $0.62 | $0.62 | $0.62 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $3.09 Median $3.09 Typical High $3.09 | Professional | 52 · Reduced service | $3.09 | $3.09 | $3.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.23 Median $1.26 Typical High $1.26 | Professional | 53 · Discontinued | $1.23 | $1.26 | $1.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4.57 Median $4.68 Typical High $4.68 | Professional | 54 · Surgery only | $4.57 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.91 Median $0.93 Typical High $0.93 | Professional | 55 · Aftercare only | $0.91 | $0.93 | $0.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.62 Median $0.62 Typical High $0.62 | Professional | 56 · Pre-op care only | $0.62 | $0.62 | $0.62 |
Where Minnesota sits
The same service costs 4.1 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
$8.51
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.