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 $41.69 Median $41.69 Typical High $43.65 | Facility | None | $41.69 | $41.69 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $42.66 Typical High $77.62 | Professional | None | $40.74 | $42.66 | $77.62 |
Ambetter Setting Professional Modifier None Typical Low $60.26 Median $93.33 Typical High $117.49 | Professional | None | $60.26 | $93.33 | $117.49 |
BCBS Tennessee Setting Professional Modifier None Typical Low $54.95 Median $70.79 Typical High $70.79 | Professional | None | $54.95 | $70.79 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $60.26 | Facility | None | $57.54 | $57.54 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $57.54 | Professional | None | $42.66 | $42.66 | $57.54 |
Lucent Health Setting Professional Modifier None Typical Low $602.56 Median $891.25 Typical High $891.25 | Professional | None | $602.56 | $891.25 | $891.25 |
United Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $51.29 | Facility | None | $43.65 | $43.65 | $51.29 |
United Setting Professional Modifier None Typical Low $30.20 Median $44.67 Typical High $58.88 | Professional | None | $30.20 | $44.67 | $58.88 |
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 $20.42 Median $20.89 Typical High $25.70 | Professional | 52 · Reduced service | $20.42 | $20.89 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.32 Typical High $10.47 | Professional | 53 · Discontinued | $8.13 | $8.32 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.31 Typical High $7.76 | Professional | 55 · Aftercare only | $6.17 | $6.31 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.17 Typical High $5.25 | Professional | 56 · Pre-op care only | $4.07 | $4.17 | $5.25 |
Cigna Setting Professional Modifier RR · Rental Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | RR · Rental | $5.75 | $5.75 | $5.75 |
Where Tennessee sits
The same service costs 2.6 times more in Hawaii than in Delaware. 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· 37th of 51
$54.95
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.