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 $48.98 Median $1,819.70 Typical High $6,606.93 | Facility | None | $48.98 | $1,819.70 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $53.70 Typical High $83.18 | Professional | None | $39.81 | $53.70 | $83.18 |
Ambetter Setting Professional Modifier None Typical Low $58.88 Median $85.11 Typical High $128.82 | Professional | None | $58.88 | $85.11 | $128.82 |
BCBS Tennessee Setting Facility Modifier None Typical Low $50.12 Median $125.89 Typical High $281.84 | Facility | None | $50.12 | $125.89 | $281.84 |
BCBS Tennessee Setting Professional Modifier None Typical Low $54.95 Median $77.62 Typical High $138.04 | Professional | None | $54.95 | $77.62 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,047.13 Typical High $2,691.53 | Facility | None | $562.34 | $1,047.13 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $72.44 Typical High $114.82 | Professional | None | $53.70 | $72.44 | $114.82 |
Lucent Health Setting Professional Modifier None Typical Low $436.52 Median $512.86 Typical High $512.86 | Professional | None | $436.52 | $512.86 | $512.86 |
United Setting Facility Modifier None Typical Low $107.15 Median $436.52 Typical High $1,778.28 | Facility | None | $107.15 | $436.52 | $1,778.28 |
United Setting Professional Modifier None Typical Low $48.98 Median $75.86 Typical High $125.89 | Professional | None | $48.98 | $75.86 | $125.89 |
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 $19.95 Median $24.55 Typical High $32.36 | Professional | 52 · Reduced service | $19.95 | $24.55 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $9.77 Typical High $12.88 | Professional | 53 · Discontinued | $7.94 | $9.77 | $12.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $37.15 Typical High $48.98 | Professional | 54 · Surgery only | $30.20 | $37.15 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $7.41 Typical High $9.77 | Professional | 55 · Aftercare only | $6.03 | $7.41 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $4.90 Typical High $6.46 | Professional | 56 · Pre-op care only | $3.98 | $4.90 | $6.46 |
Where Tennessee sits
The same service costs 4.8 times more in Alaska than in Kentucky. 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· 13th of 51
$87.10
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.