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 $29.51 Median $37.15 Typical High $42.66 | Facility | None | $29.51 | $37.15 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $30.90 | Professional | None | $29.51 | $29.51 | $30.90 |
BCBS Tennessee Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Cigna Setting Facility Modifier None Typical Low $32.36 Median $37.15 Typical High $52.48 | Facility | None | $32.36 | $37.15 | $52.48 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
United Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $30.20 | Professional | None | $28.84 | $28.84 | $30.20 |
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 $14.79 Median $14.79 Typical High $15.14 | Professional | 52 · Reduced service | $14.79 | $14.79 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $5.89 Typical High $6.17 | Professional | 53 · Discontinued | $5.89 | $5.89 | $6.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $22.39 Median $22.39 Typical High $22.91 | Professional | 54 · Surgery only | $22.39 | $22.39 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.47 Typical High $4.57 | Professional | 55 · Aftercare only | $4.47 | $4.47 | $4.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $2.95 Typical High $3.09 | Professional | 56 · Pre-op care only | $2.95 | $2.95 | $3.09 |
Where Tennessee sits
The same service costs 1.9 times more in Alaska than in Oklahoma. 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· 43rd of 51
$29.51
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.