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 $5.75 Median $10.47 Typical High $18.62 | Professional | None | $5.75 | $10.47 | $18.62 |
BCBS Tennessee Setting Facility Modifier None Typical Low $371.54 Median $724.44 Typical High $1,862.09 | Facility | None | $371.54 | $724.44 | $1,862.09 |
BCBS Tennessee Setting Professional Modifier None Typical Low $8.32 Median $12.88 Typical High $21.88 | Professional | None | $8.32 | $12.88 | $21.88 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $1,659.59 | Facility | None | $50.12 | $66.07 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $6.31 Median $12.02 Typical High $20.89 | Professional | None | $6.31 | $12.02 | $20.89 |
Lucent Health Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
United Setting Facility Modifier None Typical Low $107.15 Median $436.52 Typical High $1,778.28 | Facility | None | $107.15 | $436.52 | $1,778.28 |
United Setting Professional Modifier None Typical Low $7.59 Median $13.49 Typical High $23.44 | Professional | None | $7.59 | $13.49 | $23.44 |
6 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 $2.88 Median $4.79 Typical High $5.62 | Professional | 52 · Reduced service | $2.88 | $4.79 | $5.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.15 Median $1.91 Typical High $2.24 | Professional | 53 · Discontinued | $1.15 | $1.91 | $2.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4.37 Median $7.08 Typical High $8.32 | Professional | 54 · Surgery only | $4.37 | $7.08 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.87 Median $1.41 Typical High $1.66 | Professional | 55 · Aftercare only | $0.87 | $1.41 | $1.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.58 Median $1.05 Typical High $1.12 | Professional | 56 · Pre-op care only | $0.58 | $1.05 | $1.12 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | 59 · Distinct service | $9.12 | $9.12 | $9.12 |
Where Tennessee sits
The same service costs 3.5 times more in Alaska than in New Jersey. 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· 20th of 51
$16.98
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.