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 $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $18.62 Typical High $18.62 | Professional | None | $18.20 | $18.62 | $18.62 |
BCBS Minnesota Setting Facility Modifier None Typical Low $22.39 Median $25.12 Typical High $40.74 | Facility | None | $22.39 | $25.12 | $40.74 |
BCBS Minnesota Setting Professional Modifier None Typical Low $20.42 Median $25.12 Typical High $25.70 | Professional | None | $20.42 | $25.12 | $25.70 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $69.18 Typical High $218.78 | Facility | None | $43.65 | $69.18 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $30.90 Typical High $36.31 | Professional | None | $28.84 | $30.90 | $36.31 |
Health Partners Setting Facility Modifier None Typical Low $38.90 Median $61.66 Typical High $112.20 | Facility | None | $38.90 | $61.66 | $112.20 |
Health Partners Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Medica Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $36.31 | Facility | None | $25.12 | $25.12 | $36.31 |
Medica Setting Professional Modifier None Typical Low $8.13 Median $10.47 Typical High $199.53 | Professional | None | $8.13 | $10.47 | $199.53 |
United Setting Professional Modifier None Typical Low $7.08 Median $10.47 Typical High $20.89 | Professional | None | $7.08 | $10.47 | $20.89 |
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 $9.33 Median $9.33 Typical High $9.33 | Facility | 52 · Reduced service | $9.33 | $9.33 | $9.33 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $3.72 Median $3.72 Typical High $3.72 | Facility | 53 · Discontinued | $3.72 | $3.72 | $3.72 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $13.80 Median $13.80 Typical High $13.80 | Facility | 54 · Surgery only | $13.80 | $13.80 | $13.80 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $2.75 Median $2.75 Typical High $2.75 | Facility | 55 · Aftercare only | $2.75 | $2.75 | $2.75 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.86 Median $1.86 Typical High $1.86 | Facility | 56 · Pre-op care only | $1.86 | $1.86 | $1.86 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $9.12 Median $9.33 Typical High $9.33 | Professional | 52 · Reduced service | $9.12 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $3.72 Typical High $3.72 | Professional | 53 · Discontinued | $3.63 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $13.49 Median $13.80 Typical High $13.80 | Professional | 54 · Surgery only | $13.49 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $2.75 Typical High $2.75 | Professional | 55 · Aftercare only | $2.75 | $2.75 | $2.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $1.86 Typical High $1.86 | Professional | 56 · Pre-op care only | $1.82 | $1.86 | $1.86 |
Where Minnesota sits
The same service costs 2.8 times more in Hawaii 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· 5th of 51
$25.70
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.