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 $891.25 Median $2,290.87 Typical High $7,585.78 | Facility | None | $891.25 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $112.20 Typical High $177.83 | Professional | None | $43.65 | $112.20 | $177.83 |
Ambetter Setting Professional Modifier None Typical Low $104.71 Median $123.03 Typical High $123.03 | Professional | None | $104.71 | $123.03 | $123.03 |
BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,096.48 Typical High $2,630.27 | Facility | None | $524.81 | $1,096.48 | $2,630.27 |
BCBS Setting Professional Modifier None Typical Low $48.98 Median $117.49 Typical High $186.21 | Professional | None | $48.98 | $117.49 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $263.03 Typical High $1,659.59 | Facility | None | $134.90 | $263.03 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $93.33 Typical High $162.18 | Professional | None | $51.29 | $93.33 | $162.18 |
Lucent Health Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,288.25 | Professional | None | $933.25 | $933.25 | $1,288.25 |
United Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $2,511.89 | Facility | None | $346.74 | $1,047.13 | $2,511.89 |
United Setting Professional Modifier None Typical Low $44.67 Median $97.72 Typical High $181.97 | Professional | None | $44.67 | $97.72 | $181.97 |
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 $21.88 Median $48.98 Typical High $89.13 | Professional | 52 · Reduced service | $21.88 | $48.98 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $19.95 Typical High $35.48 | Professional | 53 · Discontinued | $8.71 | $19.95 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $72.44 Typical High $134.90 | Professional | 54 · Surgery only | $32.36 | $72.44 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $14.79 Typical High $26.92 | Professional | 55 · Aftercare only | $6.46 | $14.79 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $10.00 Typical High $17.78 | Professional | 56 · Pre-op care only | $4.37 | $10.00 | $17.78 |
Where Tennessee sits
The same service costs 3.5 times more in Alaska than in Washington, DC. 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· 23rd of 51
$120
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.