How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $2,454.71 Median $2,818.38 Typical High $7,585.78 | Facility | None | $2,454.71 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $7.41 Median $7.76 Typical High $10.23 | Professional | None | $7.41 | $7.76 | $10.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $3.63 Median $3.89 Typical High $5.13 | Professional | 52 · Reduced service | $3.63 | $3.89 | $5.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.48 Median $1.55 Typical High $2.04 | Professional | 53 · Discontinued | $1.48 | $1.55 | $2.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $5.50 Median $5.75 Typical High $7.59 | Professional | 54 · Surgery only | $5.50 | $5.75 | $7.59 |
BCBS Tennessee Setting Professional Modifier None Typical Low $7.94 Median $8.13 Typical High $8.13 | Professional | None | $7.94 | $8.13 | $8.13 |
Cigna Setting Facility Modifier None Typical Low $4.68 Median $125.89 Typical High $208.93 | Facility | None | $4.68 | $125.89 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $5.89 Median $9.55 Typical High $16.98 | Professional | None | $5.89 | $9.55 | $16.98 |
Lucent Health Setting Professional Modifier None Typical Low $363.08 Median $380.19 Typical High $380.19 | Professional | None | $363.08 | $380.19 | $380.19 |
United Setting Professional Modifier None Typical Low $7.41 Median $9.33 Typical High $17.38 | Professional | None | $7.41 | $9.33 | $17.38 |
2 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 55 · Aftercare only Typical Low $1.10 Median $1.15 Typical High $1.51 | Professional | 55 · Aftercare only | $1.10 | $1.15 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.72 Median $0.78 Typical High $1.02 | Professional | 56 · Pre-op care only | $0.72 | $0.78 | $1.02 |
Where Tennessee sits
The same service costs 2.3 times more in Hawaii than in North Carolina. 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
$12.30
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.