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 $5.37 Median $5.37 Typical High $5.37 | Facility | None | $5.37 | $5.37 | $5.37 |
Aetna Setting Professional Modifier None Typical Low $5.25 Median $5.37 Typical High $5.37 | Professional | None | $5.25 | $5.37 | $5.37 |
BCBS Minnesota Setting Facility Modifier None Typical Low $6.46 Median $7.24 Typical High $11.75 | Facility | None | $6.46 | $7.24 | $11.75 |
BCBS Minnesota Setting Professional Modifier None Typical Low $5.89 Median $7.24 Typical High $7.41 | Professional | None | $5.89 | $7.24 | $7.41 |
Cigna Setting Facility Modifier None Typical Low $12.30 Median $19.95 Typical High $61.66 | Facility | None | $12.30 | $19.95 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $8.32 Median $8.71 Typical High $10.47 | Professional | None | $8.32 | $8.71 | $10.47 |
Health Partners Setting Facility Modifier None Typical Low $10.96 Median $17.78 Typical High $32.36 | Facility | None | $10.96 | $17.78 | $32.36 |
Health Partners Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | None | $8.32 | $8.32 | $8.32 |
Medica Setting Facility Modifier None Typical Low $7.24 Median $7.24 Typical High $10.47 | Facility | None | $7.24 | $7.24 | $10.47 |
Medica Setting Professional Modifier None Typical Low $2.34 Median $3.09 Typical High $63.10 | Professional | None | $2.34 | $3.09 | $63.10 |
United Setting Professional Modifier None Typical Low $2.04 Median $3.02 Typical High $6.03 | Professional | None | $2.04 | $3.02 | $6.03 |
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 $2.69 Median $2.69 Typical High $2.69 | Facility | 52 · Reduced service | $2.69 | $2.69 | $2.69 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.07 Median $1.07 Typical High $1.07 | Facility | 53 · Discontinued | $1.07 | $1.07 | $1.07 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $3.98 Median $3.98 Typical High $3.98 | Facility | 54 · Surgery only | $3.98 | $3.98 | $3.98 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.79 Median $0.79 Typical High $0.79 | Facility | 55 · Aftercare only | $0.79 | $0.79 | $0.79 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.52 Typical High $0.52 | Facility | 56 · Pre-op care only | $0.52 | $0.52 | $0.52 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.63 Median $2.69 Typical High $2.69 | Professional | 52 · Reduced service | $2.63 | $2.69 | $2.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.05 Median $1.07 Typical High $1.07 | Professional | 53 · Discontinued | $1.05 | $1.07 | $1.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | 54 · Surgery only | $3.98 | $3.98 | $3.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | 55 · Aftercare only | $0.79 | $0.79 | $0.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.52 Typical High $0.52 | Professional | 56 · Pre-op care only | $0.52 | $0.52 | $0.52 |
Where Minnesota sits
The same service costs 2.7 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
$7.41
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.