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 $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $52.48 Typical High $60.26 | Professional | None | $51.29 | $52.48 | $60.26 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $25.70 Median $26.30 Typical High $28.84 | Professional | 52 · Reduced service | $25.70 | $26.30 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $7.94 Typical High $8.51 | Professional | 55 · Aftercare only | $7.76 | $7.94 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.25 Typical High $5.75 | Professional | 56 · Pre-op care only | $5.13 | $5.25 | $5.75 |
BCBS Tennessee Setting Professional Modifier None Typical Low $69.18 Median $89.13 Typical High $89.13 | Professional | None | $69.18 | $89.13 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $74.13 | Facility | None | $70.79 | $70.79 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $70.79 | Professional | None | $51.29 | $51.29 | $70.79 |
Lucent Health Setting Professional Modifier None Typical Low $588.84 Median $870.96 Typical High $870.96 | Professional | None | $588.84 | $870.96 | $870.96 |
United Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $63.10 | Facility | None | $57.54 | $57.54 | $63.10 |
United Setting Professional Modifier None Typical Low $37.15 Median $56.23 Typical High $72.44 | Professional | None | $37.15 | $56.23 | $72.44 |
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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $10.47 Typical High $10.96 | Professional | 53 · Discontinued | $10.47 | $10.47 | $10.96 |
Where Tennessee sits
The same service costs 2.4 times more in Montana 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· 41st of 51
$58.88
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.