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 $36.31 Median $74.13 Typical High $141.25 | Professional | None | $36.31 | $74.13 | $141.25 |
Ambetter Setting Professional Modifier None Typical Low $87.10 Median $102.33 Typical High $102.33 | Professional | None | $87.10 | $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 $46.77 Median $85.11 Typical High $162.18 | Professional | None | $46.77 | $85.11 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $100.00 Typical High $186.21 | Facility | None | $50.12 | $100.00 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $83.18 Typical High $158.49 | Professional | None | $38.02 | $83.18 | $158.49 |
Lucent Health Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $954.99 | Professional | None | $812.83 | $812.83 | $954.99 |
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 $44.67 Median $85.11 Typical High $169.82 | Professional | None | $44.67 | $85.11 | $169.82 |
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 $17.78 Median $26.92 Typical High $61.66 | Professional | 52 · Reduced service | $17.78 | $26.92 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $10.72 Typical High $25.12 | Professional | 53 · Discontinued | $7.08 | $10.72 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $26.92 Median $40.74 Typical High $93.33 | Professional | 54 · Surgery only | $26.92 | $40.74 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $8.13 Typical High $18.62 | Professional | 55 · Aftercare only | $5.37 | $8.13 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $5.37 Typical High $12.59 | Professional | 56 · Pre-op care only | $3.55 | $5.37 | $12.59 |
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· 11th of 51
$123
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.