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 $891.25 Median $2,290.87 Typical High $7,585.78 | Facility | None | $891.25 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $79.43 Typical High $147.91 | Professional | None | $43.65 | $79.43 | $147.91 |
Ambetter Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
BCBS Tennessee Setting Facility Modifier None Typical Low $371.54 Median $724.44 Typical High $1,862.09 | Facility | None | $371.54 | $724.44 | $1,862.09 |
BCBS Tennessee Setting Professional Modifier None Typical Low $63.10 Median $109.65 Typical High $194.98 | Professional | None | $63.10 | $109.65 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $75.86 Typical High $162.18 | Facility | None | $50.12 | $75.86 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $107.15 Typical High $186.21 | Professional | None | $58.88 | $107.15 | $186.21 |
Lucent Health Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $870.96 | Professional | None | $724.44 | $724.44 | $870.96 |
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 $57.54 Median $112.20 Typical High $208.93 | Professional | None | $57.54 | $112.20 | $208.93 |
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 $21.38 Median $33.11 Typical High $53.70 | Professional | 52 · Reduced service | $21.38 | $33.11 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $13.18 Typical High $21.88 | Professional | 53 · Discontinued | $8.71 | $13.18 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $50.12 Typical High $81.28 | Professional | 54 · Surgery only | $32.36 | $50.12 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $10.00 Typical High $16.22 | Professional | 55 · Aftercare only | $6.46 | $10.00 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $6.61 Typical High $10.96 | Professional | 56 · Pre-op care only | $4.37 | $6.61 | $10.96 |
Where Tennessee sits
The same service costs 2.8 times more in Alaska than in Pennsylvania. 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· 15th of 51
$132
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.