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 $1,819.70 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,819.70 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $316.23 Typical High $2,570.40 | Professional | None | $223.87 | $316.23 | $2,570.40 |
BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $4,897.79 Typical High $10,471.29 | Facility | None | $1,288.25 | $4,897.79 | $10,471.29 |
BCBS Setting Professional Modifier None Typical Low $380.19 Median $489.78 Typical High $794.33 | Professional | None | $380.19 | $489.78 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $8,128.31 Typical High $16,595.87 | Facility | None | $602.56 | $8,128.31 | $16,595.87 |
Lucent Health Setting Professional Modifier None Typical Low $2,570.40 Median $3,162.28 Typical High $3,162.28 | Professional | None | $2,570.40 | $3,162.28 | $3,162.28 |
United Setting Facility Modifier None Typical Low $3,630.78 Median $10,000.00 Typical High $15,848.93 | Facility | None | $3,630.78 | $10,000.00 | $15,848.93 |
United Setting Professional Modifier None Typical Low $309.03 Median $478.63 Typical High $794.33 | Professional | None | $309.03 | $478.63 | $794.33 |
5 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 Professional Modifier 52 · Reduced service Typical Low $112.20 Median $128.82 Typical High $158.49 | Professional | 52 · Reduced service | $112.20 | $128.82 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $51.29 Typical High $64.57 | Professional | 53 · Discontinued | $44.67 | $51.29 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $190.55 Typical High $239.88 | Professional | 54 · Surgery only | $165.96 | $190.55 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $38.02 Typical High $47.86 | Professional | 55 · Aftercare only | $33.88 | $38.02 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $25.70 Typical High $31.62 | Professional | 56 · Pre-op care only | $22.39 | $25.70 | $31.62 |
Where Tennessee sits
The same service costs 15.8 times more in Arkansas 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.
Tennessee· 8th of 51
$3,162
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.