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 $8.71 Median $8.71 Typical High $8.71 | Facility | None | $8.71 | $8.71 | $8.71 |
Aetna Setting Professional Modifier None Typical Low $8.32 Median $8.71 Typical High $8.71 | Professional | None | $8.32 | $8.71 | $8.71 |
BCBS Minnesota Setting Facility Modifier None Typical Low $10.47 Median $11.75 Typical High $19.05 | Facility | None | $10.47 | $11.75 | $19.05 |
BCBS Minnesota Setting Professional Modifier None Typical Low $9.55 Median $11.75 Typical High $12.02 | Professional | None | $9.55 | $11.75 | $12.02 |
Cigna Setting Facility Modifier None Typical Low $20.42 Median $32.36 Typical High $102.33 | Facility | None | $20.42 | $32.36 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $13.49 Median $14.45 Typical High $16.98 | Professional | None | $13.49 | $14.45 | $16.98 |
Health Partners Setting Facility Modifier None Typical Low $18.20 Median $28.84 Typical High $52.48 | Facility | None | $18.20 | $28.84 | $52.48 |
Health Partners Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | None | $13.49 | $13.49 | $13.49 |
Medica Setting Facility Modifier None Typical Low $11.75 Median $11.75 Typical High $37.15 | Facility | None | $11.75 | $11.75 | $37.15 |
Medica Setting Professional Modifier None Typical Low $3.80 Median $4.90 Typical High $138.04 | Professional | None | $3.80 | $4.90 | $138.04 |
United Setting Professional Modifier None Typical Low $3.31 Median $4.79 Typical High $9.77 | Professional | None | $3.31 | $4.79 | $9.77 |
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 $4.37 Median $4.37 Typical High $4.37 | Facility | 52 · Reduced service | $4.37 | $4.37 | $4.37 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.74 Median $1.74 Typical High $1.74 | Facility | 53 · Discontinued | $1.74 | $1.74 | $1.74 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $6.46 Median $6.46 Typical High $6.46 | Facility | 54 · Surgery only | $6.46 | $6.46 | $6.46 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $1.29 Median $1.29 Typical High $1.29 | Facility | 55 · Aftercare only | $1.29 | $1.29 | $1.29 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.85 Median $0.85 Typical High $0.85 | Facility | 56 · Pre-op care only | $0.85 | $0.85 | $0.85 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $4.27 Median $4.37 Typical High $4.37 | Professional | 52 · Reduced service | $4.27 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.70 Median $1.74 Typical High $1.74 | Professional | 53 · Discontinued | $1.70 | $1.74 | $1.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $6.31 Median $6.46 Typical High $6.46 | Professional | 54 · Surgery only | $6.31 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.26 Median $1.29 Typical High $1.29 | Professional | 55 · Aftercare only | $1.26 | $1.29 | $1.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.85 Median $0.85 Typical High $0.85 | Professional | 56 · Pre-op care only | $0.85 | $0.85 | $0.85 |
Where Minnesota sits
The same service costs 2.9 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
$11.75
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.