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 $18.20 Median $24.55 Typical High $28.84 | Facility | None | $18.20 | $24.55 | $28.84 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.62 | Professional | None | $18.20 | $18.20 | $18.62 |
BCBS Tennessee Setting Professional Modifier None Typical Low $19.50 Median $19.95 Typical High $19.95 | Professional | None | $19.50 | $19.95 | $19.95 |
Cigna Setting Facility Modifier None Typical Low $18.62 Median $22.91 Typical High $29.51 | Facility | None | $18.62 | $22.91 | $29.51 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
United Setting Professional Modifier None Typical Low $19.50 Median $20.42 Typical High $32.36 | Professional | None | $19.50 | $20.42 | $32.36 |
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 $9.12 Median $9.12 Typical High $9.33 | Professional | 52 · Reduced service | $9.12 | $9.12 | $9.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $3.63 Typical High $3.72 | Professional | 53 · Discontinued | $3.63 | $3.63 | $3.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $2.69 Typical High $2.82 | Professional | 55 · Aftercare only | $2.69 | $2.69 | $2.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $1.82 Typical High $1.86 | Professional | 56 · Pre-op care only | $1.82 | $1.82 | $1.86 |
Where Tennessee sits
The same service costs 2.1 times more in Oklahoma 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· 24th of 51
$19.95
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.