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 $100.00 Median $102.33 Typical High $162.18 | Professional | None | $100.00 | $102.33 | $162.18 |
BCBS Setting Facility Modifier None Typical Low $398.11 Median $741.31 Typical High $1,862.09 | Facility | None | $398.11 | $741.31 | $1,862.09 |
BCBS Setting Professional Modifier None Typical Low $114.82 Median $151.36 Typical High $281.84 | Professional | None | $114.82 | $151.36 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $512.86 Typical High $1,659.59 | Facility | None | $389.05 | $512.86 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $128.82 Typical High $234.42 | Professional | None | $100.00 | $128.82 | $234.42 |
Lucent Health Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,000.00 | Professional | None | $794.33 | $794.33 | $1,000.00 |
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 $102.33 Median $147.91 Typical High $239.88 | Professional | None | $102.33 | $147.91 | $239.88 |
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 $50.12 Median $51.29 Typical High $74.13 | Professional | 52 · Reduced service | $50.12 | $51.29 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $20.42 Typical High $29.51 | Professional | 53 · Discontinued | $19.95 | $20.42 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $77.62 Typical High $109.65 | Professional | 54 · Surgery only | $75.86 | $77.62 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.49 Typical High $21.88 | Professional | 55 · Aftercare only | $15.14 | $15.49 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.23 Typical High $14.79 | Professional | 56 · Pre-op care only | $10.00 | $10.23 | $14.79 |
Where Tennessee sits
The same service costs 4.4 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· 4th of 51
$437
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.