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 $7.94 Median $7.94 Typical High $11.75 | Facility | None | $7.94 | $7.94 | $11.75 |
Aetna Setting Professional Modifier None Typical Low $7.94 Median $7.94 Typical High $8.91 | Professional | None | $7.94 | $7.94 | $8.91 |
BCBS Tennessee Setting Professional Modifier None Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | None | $7.94 | $7.94 | $7.94 |
Cigna Setting Facility Modifier None Typical Low $7.59 Median $10.23 Typical High $13.18 | Facility | None | $7.59 | $10.23 | $13.18 |
Cigna Setting Professional Modifier None Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | None | $7.94 | $7.94 | $7.94 |
United Setting Professional Modifier None Typical Low $7.94 Median $8.32 Typical High $12.02 | Professional | None | $7.94 | $8.32 | $12.02 |
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 $3.98 Median $3.98 Typical High $4.07 | Professional | 52 · Reduced service | $3.98 | $3.98 | $4.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.58 Median $1.58 Typical High $1.62 | Professional | 53 · Discontinued | $1.58 | $1.58 | $1.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.20 Median $1.20 Typical High $1.23 | Professional | 55 · Aftercare only | $1.20 | $1.20 | $1.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.79 Median $0.79 Typical High $0.81 | Professional | 56 · Pre-op care only | $0.79 | $0.79 | $0.81 |
Where Tennessee sits
The same service costs 1.9 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· 50th of 51
$7.94
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.