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 $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $218.78 Typical High $288.40 | Professional | None | $208.93 | $218.78 | $288.40 |
BCBS Tennessee Setting Professional Modifier None Typical Low $173.78 Median $190.55 Typical High $295.12 | Professional | None | $173.78 | $190.55 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $181.97 Typical High $269.15 | Facility | None | $162.18 | $181.97 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $204.17 Typical High $323.59 | Professional | None | $112.20 | $204.17 | $323.59 |
Lucent Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,513.56 | $1,905.46 | $1,905.46 |
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 $181.97 Median $208.93 Typical High $354.81 | Professional | None | $181.97 | $208.93 | $354.81 |
4 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 $104.71 Median $109.65 Typical High $138.04 | Professional | 52 · Reduced service | $104.71 | $109.65 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $43.65 Typical High $56.23 | Professional | 53 · Discontinued | $41.69 | $43.65 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $33.11 Typical High $41.69 | Professional | 55 · Aftercare only | $30.90 | $33.11 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $21.88 Typical High $28.18 | Professional | 56 · Pre-op care only | $20.89 | $21.88 | $28.18 |
Where Tennessee sits
The same service costs 3.0 times more in Wisconsin than in Florida. 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· 33rd 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.