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 $0.32 Median $0.32 Typical High $0.32 | Facility | None | $0.32 | $0.32 | $0.32 |
Aetna Setting Professional Modifier None Typical Low $0.32 Median $0.32 Typical High $0.40 | Professional | None | $0.32 | $0.32 | $0.40 |
BCBS Tennessee Setting Professional Modifier None Typical Low $0.44 Median $0.58 Typical High $0.58 | Professional | None | $0.44 | $0.58 | $0.58 |
Cigna Setting Facility Modifier None Typical Low $0.42 Median $0.42 Typical High $0.44 | Facility | None | $0.42 | $0.42 | $0.44 |
Cigna Setting Professional Modifier None Typical Low $0.36 Median $0.36 Typical High $0.42 | Professional | None | $0.36 | $0.36 | $0.42 |
Lucent Health Setting Professional Modifier None Typical Low $3.89 Median $5.62 Typical High $5.62 | Professional | None | $3.89 | $5.62 | $5.62 |
United Setting Professional Modifier None Typical Low $0.25 Median $0.36 Typical High $0.50 | Professional | None | $0.25 | $0.36 | $0.50 |
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 $0.16 Median $0.16 Typical High $0.20 | Professional | 52 · Reduced service | $0.16 | $0.16 | $0.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.06 Median $0.06 Typical High $0.08 | Professional | 53 · Discontinued | $0.06 | $0.06 | $0.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.05 Typical High $0.06 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.06 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.03 | $0.03 | $0.04 |
Where Tennessee sits
The same service costs 2.3 times more in Montana than in Hawaii. 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· 38th of 51
$0.42
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.