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 $109.65 Median $123.03 Typical High $162.18 | Professional | None | $109.65 | $123.03 | $162.18 |
BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,122.02 Typical High $2,570.40 | Facility | None | $524.81 | $1,122.02 | $2,570.40 |
BCBS Setting Professional Modifier None Typical Low $144.54 Median $194.98 Typical High $323.59 | Professional | None | $144.54 | $194.98 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $79.43 Typical High $162.18 | Facility | None | $50.12 | $79.43 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $269.15 | Professional | None | $117.49 | $158.49 | $269.15 |
Lucent Health Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,090.30 | Professional | None | $3,090.30 | $3,090.30 | $3,090.30 |
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 $125.89 Median $194.98 Typical High $302.00 | Professional | None | $125.89 | $194.98 | $302.00 |
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 $51.29 Median $60.26 Typical High $69.18 | Professional | 52 · Reduced service | $51.29 | $60.26 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $24.55 Typical High $28.18 | Professional | 53 · Discontinued | $20.42 | $24.55 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $91.20 Typical High $104.71 | Professional | 54 · Surgery only | $75.86 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $18.20 Typical High $20.89 | Professional | 55 · Aftercare only | $15.14 | $18.20 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $12.02 Typical High $14.13 | Professional | 56 · Pre-op care only | $10.23 | $12.02 | $14.13 |
Where Tennessee sits
The same service costs 2.9 times more in Alaska than in Kentucky. 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· 17th of 51
$209
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.