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 $11.22 Median $11.22 Typical High $11.22 | Facility | None | $11.22 | $11.22 | $11.22 |
Aetna Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $15.14 | Professional | None | $11.22 | $11.22 | $15.14 |
BCBS Minnesota Setting Facility Modifier None Typical Low $13.80 Median $15.14 Typical High $25.12 | Facility | None | $13.80 | $15.14 | $25.12 |
BCBS Minnesota Setting Professional Modifier None Typical Low $12.30 Median $15.14 Typical High $15.49 | Professional | None | $12.30 | $15.14 | $15.49 |
Cigna Setting Facility Modifier None Typical Low $26.30 Median $42.66 Typical High $131.83 | Facility | None | $26.30 | $42.66 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $18.62 Typical High $22.39 | Professional | None | $17.78 | $18.62 | $22.39 |
Health Partners Setting Facility Modifier None Typical Low $23.44 Median $38.02 Typical High $69.18 | Facility | None | $23.44 | $38.02 | $69.18 |
Health Partners Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
Medica Setting Facility Modifier None Typical Low $15.14 Median $15.14 Typical High $36.31 | Facility | None | $15.14 | $15.14 | $36.31 |
Medica Setting Professional Modifier None Typical Low $5.01 Median $6.46 Typical High $295.12 | Professional | None | $5.01 | $6.46 | $295.12 |
United Setting Professional Modifier None Typical Low $4.27 Median $6.31 Typical High $12.59 | Professional | None | $4.27 | $6.31 | $12.59 |
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 $5.62 Median $5.62 Typical High $5.62 | Facility | 52 · Reduced service | $5.62 | $5.62 | $5.62 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.24 Median $2.24 Typical High $2.24 | Facility | 53 · Discontinued | $2.24 | $2.24 | $2.24 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $8.51 Median $8.51 Typical High $8.51 | Facility | 54 · Surgery only | $8.51 | $8.51 | $8.51 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $1.70 Median $1.70 Typical High $1.70 | Facility | 55 · Aftercare only | $1.70 | $1.70 | $1.70 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.12 Typical High $1.12 | Facility | 56 · Pre-op care only | $1.12 | $1.12 | $1.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $5.50 Median $5.62 Typical High $5.62 | Professional | 52 · Reduced service | $5.50 | $5.62 | $5.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.19 Median $2.24 Typical High $2.24 | Professional | 53 · Discontinued | $2.19 | $2.24 | $2.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.32 Median $8.51 Typical High $8.51 | Professional | 54 · Surgery only | $8.32 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.66 Median $1.70 Typical High $1.70 | Professional | 55 · Aftercare only | $1.66 | $1.70 | $1.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.10 Median $1.12 Typical High $1.12 | Professional | 56 · Pre-op care only | $1.10 | $1.12 | $1.12 |
Where Minnesota sits
The same service costs 4.5 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
$15.14
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.