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 $35.48 Median $35.48 Typical High $57.54 | Facility | None | $35.48 | $35.48 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $35.48 Median $57.54 Typical High $81.28 | Professional | None | $35.48 | $57.54 | $81.28 |
Ambetter Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
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 $70.79 Typical High $104.71 | Professional | None | $46.77 | $70.79 | $104.71 |
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 $38.02 Median $66.07 Typical High $107.15 | Professional | None | $38.02 | $66.07 | $107.15 |
Lucent Health Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $776.25 | Professional | None | $575.44 | $575.44 | $776.25 |
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 $69.18 Typical High $114.82 | Professional | None | $44.67 | $69.18 | $114.82 |
4 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 $28.18 Typical High $38.90 | Professional | 52 · Reduced service | $17.78 | $28.18 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $11.22 Typical High $15.85 | Professional | 53 · Discontinued | $7.08 | $11.22 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $8.32 Typical High $11.75 | Professional | 55 · Aftercare only | $5.37 | $8.32 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $5.62 Typical High $7.76 | Professional | 56 · Pre-op care only | $3.55 | $5.62 | $7.76 |
Where Tennessee sits
The same service costs 3.3 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· 17th of 51
$83.18
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.