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 $0.32 Median $0.32 Typical High $0.32 | Facility | None | $0.32 | $0.32 | $0.32 |
Aetna Setting Professional Modifier None Typical Low $0.32 Median $0.32 Typical High $0.36 | Professional | None | $0.32 | $0.32 | $0.36 |
BCBS Minnesota Setting Facility Modifier None Typical Low $0.27 Median $0.58 Typical High $0.60 | Facility | None | $0.27 | $0.58 | $0.60 |
BCBS Minnesota Setting Professional Modifier None Typical Low $0.22 Median $0.25 Typical High $0.28 | Professional | None | $0.22 | $0.25 | $0.28 |
Cigna Setting Facility Modifier None Typical Low $0.34 Median $0.71 Typical High $0.93 | Facility | None | $0.34 | $0.71 | $0.93 |
Cigna Setting Professional Modifier None Typical Low $0.34 Median $0.36 Typical High $0.43 | Professional | None | $0.34 | $0.36 | $0.43 |
Health Partners Setting Facility Modifier None Typical Low $0.27 Median $0.66 Typical High $0.98 | Facility | None | $0.27 | $0.66 | $0.98 |
Health Partners Setting Professional Modifier None Typical Low $0.34 Median $0.34 Typical High $0.34 | Professional | None | $0.34 | $0.34 | $0.34 |
Medica Setting Facility Modifier None Typical Low $0.28 Median $0.62 Typical High $0.89 | Facility | None | $0.28 | $0.62 | $0.89 |
Medica Setting Professional Modifier None Typical Low $0.28 Median $0.32 Typical High $0.52 | Professional | None | $0.28 | $0.32 | $0.52 |
United Setting Facility Modifier None Typical Low $0.32 Median $0.32 Typical High $0.32 | Facility | None | $0.32 | $0.32 | $0.32 |
United Setting Professional Modifier None Typical Low $0.28 Median $0.31 Typical High $0.52 | Professional | None | $0.28 | $0.31 | $0.52 |
8 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 $0.16 Median $0.16 Typical High $0.16 | Facility | 52 · Reduced service | $0.16 | $0.16 | $0.16 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.06 Median $0.06 Typical High $0.06 | Facility | 53 · Discontinued | $0.06 | $0.06 | $0.06 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.05 Median $0.05 Typical High $0.05 | Facility | 55 · Aftercare only | $0.05 | $0.05 | $0.05 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.03 | Facility | 56 · Pre-op care only | $0.03 | $0.03 | $0.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.16 Median $0.16 Typical High $0.17 | Professional | 52 · Reduced service | $0.16 | $0.16 | $0.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.06 Median $0.06 Typical High $0.07 | Professional | 53 · Discontinued | $0.06 | $0.06 | $0.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | 56 · Pre-op care only | $0.03 | $0.03 | $0.03 |
Where Minnesota sits
The same service costs 2.8 times more in Texas than in Rhode Island. 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· 40th of 51
$0.32
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.