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 $13.49 Median $13.49 Typical High $13.49 | Facility | None | $13.49 | $13.49 | $13.49 |
Aetna Setting Professional Modifier None Typical Low $12.88 Median $13.49 Typical High $13.49 | Professional | None | $12.88 | $13.49 | $13.49 |
BCBS Minnesota Setting Facility Modifier None Typical Low $16.22 Median $18.20 Typical High $29.51 | Facility | None | $16.22 | $18.20 | $29.51 |
BCBS Minnesota Setting Professional Modifier None Typical Low $14.79 Median $16.60 Typical High $18.20 | Professional | None | $14.79 | $16.60 | $18.20 |
Cigna Setting Facility Modifier None Typical Low $31.62 Median $50.12 Typical High $158.49 | Facility | None | $31.62 | $50.12 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $22.39 Typical High $26.92 | Professional | None | $21.38 | $22.39 | $26.92 |
Health Partners Setting Facility Modifier None Typical Low $28.18 Median $45.71 Typical High $83.18 | Facility | None | $28.18 | $45.71 | $83.18 |
Health Partners Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
Medica Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $26.30 | Facility | None | $18.20 | $18.20 | $26.30 |
Medica Setting Professional Modifier None Typical Low $5.89 Median $7.59 Typical High $151.36 | Professional | None | $5.89 | $7.59 | $151.36 |
United Setting Professional Modifier None Typical Low $5.13 Median $7.59 Typical High $15.14 | Professional | None | $5.13 | $7.59 | $15.14 |
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 $6.61 Median $6.61 Typical High $6.61 | Facility | 52 · Reduced service | $6.61 | $6.61 | $6.61 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.69 Median $2.69 Typical High $2.69 | Facility | 53 · Discontinued | $2.69 | $2.69 | $2.69 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $10.00 Median $10.00 Typical High $10.00 | Facility | 54 · Surgery only | $10.00 | $10.00 | $10.00 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $2.00 Median $2.00 Typical High $2.00 | Facility | 55 · Aftercare only | $2.00 | $2.00 | $2.00 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.32 Median $1.32 Typical High $1.32 | Facility | 56 · Pre-op care only | $1.32 | $1.32 | $1.32 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | 52 · Reduced service | $6.61 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.63 Median $2.69 Typical High $2.69 | Professional | 53 · Discontinued | $2.63 | $2.69 | $2.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $9.77 Median $10.00 Typical High $10.00 | Professional | 54 · Surgery only | $9.77 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.95 Median $2.00 Typical High $2.00 | Professional | 55 · Aftercare only | $1.95 | $2.00 | $2.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.32 Median $1.32 Typical High $1.32 | Professional | 56 · Pre-op care only | $1.32 | $1.32 | $1.32 |
Where Minnesota sits
The same service costs 2.7 times more in Idaho 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· 4th of 51
$18.20
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.