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 $1,479.11 Median $2,454.71 Typical High $7,585.78 | Facility | None | $1,479.11 | $2,454.71 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $177.83 Typical High $245.47 | Professional | None | $165.96 | $177.83 | $245.47 |
BCBS Setting Facility Modifier None Typical Low $50.12 Median $138.04 Typical High $1,148.15 | Facility | None | $50.12 | $138.04 | $1,148.15 |
BCBS Setting Professional Modifier None Typical Low $169.82 Median $218.78 Typical High $288.40 | Professional | None | $169.82 | $218.78 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,148.15 Typical High $2,691.53 | Facility | None | $512.86 | $1,148.15 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $218.78 Typical High $295.12 | Professional | None | $162.18 | $218.78 | $295.12 |
Lucent Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,348.96 | Professional | None | $1,288.25 | $1,288.25 | $1,348.96 |
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 $144.54 Median $199.53 Typical High $371.54 | Professional | None | $144.54 | $199.53 | $371.54 |
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 $83.18 Median $85.11 Typical High $117.49 | Professional | 52 · Reduced service | $83.18 | $85.11 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $33.88 Typical High $46.77 | Professional | 53 · Discontinued | $33.11 | $33.88 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $128.82 Typical High $177.83 | Professional | 54 · Surgery only | $125.89 | $128.82 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $25.70 Typical High $35.48 | Professional | 55 · Aftercare only | $25.12 | $25.70 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $16.98 Typical High $23.44 | Professional | 56 · Pre-op care only | $16.60 | $16.98 | $23.44 |
Where Tennessee sits
The same service costs 4.5 times more in Alaska 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· 28th of 51
$234
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.