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 $128.82 Median $1,905.46 Typical High $6,606.93 | Facility | None | $128.82 | $1,905.46 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $125.89 Typical High $190.55 | Professional | None | $74.13 | $125.89 | $190.55 |
Ambetter Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $72.44 | Professional | None | $39.81 | $39.81 | $72.44 |
BCBS Tennessee Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $1,949.84 | Facility | None | $407.38 | $812.83 | $1,949.84 |
BCBS Tennessee Setting Professional Modifier None Typical Low $102.33 Median $144.54 Typical High $229.09 | Professional | None | $102.33 | $144.54 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $208.93 Typical High $1,659.59 | Facility | None | $107.15 | $208.93 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $131.83 Typical High $223.87 | Professional | None | $77.62 | $131.83 | $223.87 |
Lucent Health Setting Professional Modifier None Typical Low $3,715.35 Median $3,890.45 Typical High $3,890.45 | Professional | None | $3,715.35 | $3,890.45 | $3,890.45 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,445.44 Typical High $3,630.78 | Facility | None | $512.86 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $93.33 Median $147.91 Typical High $245.47 | Professional | None | $93.33 | $147.91 | $245.47 |
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 $37.15 Median $56.23 Typical High $85.11 | Professional | 52 · Reduced service | $37.15 | $56.23 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $22.39 Typical High $33.88 | Professional | 53 · Discontinued | $14.79 | $22.39 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $83.18 Typical High $128.82 | Professional | 54 · Surgery only | $56.23 | $83.18 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $16.98 Typical High $25.70 | Professional | 55 · Aftercare only | $11.22 | $16.98 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $11.22 Typical High $16.98 | Professional | 56 · Pre-op care only | $7.41 | $11.22 | $16.98 |
Where Tennessee sits
The same service costs 3.2 times more in Alaska than in New Jersey. 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· 16th of 51
$186
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.