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 $1,819.70 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,819.70 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $87.10 Typical High $147.91 | Professional | None | $41.69 | $87.10 | $147.91 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $125.89 | Professional | None | $107.15 | $107.15 | $125.89 |
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 $54.95 Median $97.72 Typical High $173.78 | Professional | None | $54.95 | $97.72 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $1,659.59 | Facility | None | $50.12 | $66.07 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $93.33 Typical High $169.82 | Professional | None | $42.66 | $93.33 | $169.82 |
Lucent Health Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,000.00 | Professional | None | $870.96 | $870.96 | $1,000.00 |
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 $50.12 Median $95.50 Typical High $177.83 | Professional | None | $50.12 | $95.50 | $177.83 |
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 $30.20 Typical High $66.07 | Professional | 52 · Reduced service | $19.95 | $30.20 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $12.02 Typical High $26.30 | Professional | 53 · Discontinued | $8.13 | $12.02 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $45.71 Typical High $97.72 | Professional | 54 · Surgery only | $30.20 | $45.71 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $9.12 Typical High $19.50 | Professional | 55 · Aftercare only | $6.03 | $9.12 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $6.03 Typical High $13.18 | Professional | 56 · Pre-op care only | $4.07 | $6.03 | $13.18 |
Where Tennessee sits
The same service costs 3.5 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
$129
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.