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 $109.65 Median $134.90 Typical High $165.96 | Facility | None | $109.65 | $134.90 | $165.96 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $112.20 | Professional | None | $109.65 | $109.65 | $112.20 |
BCBS Tennessee Setting Professional Modifier None Typical Low $104.71 Median $107.15 Typical High $107.15 | Professional | None | $104.71 | $107.15 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $134.90 Typical High $194.98 | Facility | None | $120.23 | $134.90 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
United Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $112.20 | Professional | None | $104.71 | $104.71 | $112.20 |
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 $54.95 Median $54.95 Typical High $56.23 | Professional | 52 · Reduced service | $54.95 | $54.95 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $22.39 | Professional | 53 · Discontinued | $21.88 | $21.88 | $22.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $83.18 Typical High $85.11 | Professional | 54 · Surgery only | $83.18 | $83.18 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $16.60 Typical High $16.98 | Professional | 55 · Aftercare only | $16.60 | $16.60 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $11.22 | Professional | 56 · Pre-op care only | $10.96 | $10.96 | $11.22 |
Where Tennessee sits
The same service costs 5.0 times more in Alabama than in Maryland. 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· 38th of 51
$110
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.