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 $3.24 Median $4.07 Typical High $4.90 | Facility | None | $3.24 | $4.07 | $4.90 |
Aetna Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.31 | Professional | None | $3.24 | $3.24 | $3.31 |
BCBS Tennessee Setting Professional Modifier None Typical Low $3.24 Median $3.31 Typical High $3.31 | Professional | None | $3.24 | $3.31 | $3.31 |
Cigna Setting Facility Modifier None Typical Low $3.55 Median $3.98 Typical High $5.75 | Facility | None | $3.55 | $3.98 | $5.75 |
Cigna Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | None | $3.24 | $3.24 | $3.24 |
United Setting Professional Modifier None Typical Low $3.02 Median $3.24 Typical High $3.24 | Professional | None | $3.02 | $3.24 | $3.24 |
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 $1.62 Median $1.62 Typical High $1.66 | Professional | 52 · Reduced service | $1.62 | $1.62 | $1.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.65 Median $0.65 Typical High $0.68 | Professional | 53 · Discontinued | $0.65 | $0.65 | $0.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2.45 Median $2.45 Typical High $2.51 | Professional | 54 · Surgery only | $2.45 | $2.45 | $2.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.49 Median $0.49 Typical High $0.50 | Professional | 55 · Aftercare only | $0.49 | $0.49 | $0.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.32 Median $0.32 Typical High $0.33 | Professional | 56 · Pre-op care only | $0.32 | $0.32 | $0.33 |
Where Tennessee sits
The same service costs 1.7 times more in Arizona than in North Dakota. 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· 20th of 51
$3.31
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.