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 $1.12 Median $1.95 Typical High $1.95 | Facility | None | $1.12 | $1.95 | $1.95 |
Aetna Setting Professional Modifier None Typical Low $0.93 Median $1.95 Typical High $2.04 | Professional | None | $0.93 | $1.95 | $2.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.14 Median $0.28 Typical High $0.28 | Professional | 55 · Aftercare only | $0.14 | $0.28 | $0.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.09 Median $0.19 Typical High $0.19 | Professional | 56 · Pre-op care only | $0.09 | $0.19 | $0.19 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.10 | Professional | None | $1.00 | $1.00 | $1.10 |
Cigna Setting Facility Modifier None Typical Low $2.14 Median $2.40 Typical High $3.39 | Facility | None | $2.14 | $2.40 | $3.39 |
Cigna Setting Professional Modifier None Typical Low $0.93 Median $1.95 Typical High $1.95 | Professional | None | $0.93 | $1.95 | $1.95 |
United Setting Professional Modifier None Typical Low $0.36 Median $0.91 Typical High $0.93 | Professional | None | $0.36 | $0.91 | $0.93 |
1 more rate 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $1.55 Median $1.55 Typical High $1.55 | Professional | JZ · No drug discarded | $1.55 | $1.55 | $1.55 |
Where Tennessee sits
The same service costs 2.3 times more in Arkansas 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· 9th of 51
$1.95
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.