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 $6.17 Median $6.17 Typical High $6.17 | Facility | None | $6.17 | $6.17 | $6.17 |
Aetna Setting Professional Modifier None Typical Low $6.17 Median $6.31 Typical High $12.02 | Professional | None | $6.17 | $6.31 | $12.02 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $3.02 Median $3.09 Typical High $3.98 | Professional | 52 · Reduced service | $3.02 | $3.09 | $3.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.23 Median $1.23 Typical High $1.58 | Professional | 53 · Discontinued | $1.23 | $1.23 | $1.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.91 Median $0.93 Typical High $1.17 | Professional | 55 · Aftercare only | $0.91 | $0.93 | $1.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.62 Median $0.62 Typical High $0.79 | Professional | 56 · Pre-op care only | $0.62 | $0.62 | $0.79 |
Ambetter Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $15.14 | Professional | None | $8.51 | $8.51 | $15.14 |
BCBS Tennessee Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | None | $14.45 | $14.45 | $14.45 |
Cigna Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $22.39 | Facility | None | $20.89 | $20.89 | $22.39 |
Cigna Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $20.89 | Professional | None | $15.49 | $15.49 | $20.89 |
Lucent Health Setting Professional Modifier None Typical Low $89.13 Median $107.15 Typical High $107.15 | Professional | None | $89.13 | $107.15 | $107.15 |
United Setting Professional Modifier None Typical Low $5.37 Median $7.24 Typical High $12.02 | Professional | None | $5.37 | $7.24 | $12.02 |
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 |
|---|---|---|---|---|---|
Cigna Setting Professional Modifier RR · Rental Typical Low $2.09 Median $2.09 Typical High $2.09 | Professional | RR · Rental | $2.09 | $2.09 | $2.09 |
Where Tennessee sits
The same service costs 6.2 times more in Wyoming 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· 42nd of 51
$10.72
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.