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 $1.74 Median $5.01 Typical High $10.96 | Professional | None | $1.74 | $5.01 | $10.96 |
Ambetter Setting Professional Modifier None Typical Low $4.57 Median $5.89 Typical High $8.32 | Professional | None | $4.57 | $5.89 | $8.32 |
BCBS Tennessee Setting Facility Modifier None Typical Low $50.12 Median $125.89 Typical High $281.84 | Facility | None | $50.12 | $125.89 | $281.84 |
BCBS Tennessee Setting Professional Modifier None Typical Low $2.34 Median $5.75 Typical High $8.71 | Professional | None | $2.34 | $5.75 | $8.71 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $1,659.59 Typical High $2,691.53 | Facility | None | $52.48 | $1,659.59 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1.74 Median $5.13 Typical High $10.00 | Professional | None | $1.74 | $5.13 | $10.00 |
Lucent Health Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
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 $2.09 Median $5.62 Typical High $10.47 | Professional | None | $2.09 | $5.62 | $10.47 |
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 $0.83 Median $1.26 Typical High $3.47 | Professional | 52 · Reduced service | $0.83 | $1.26 | $3.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.34 Median $0.98 Typical High $1.38 | Professional | 53 · Discontinued | $0.34 | $0.98 | $1.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.26 Median $3.63 Typical High $5.13 | Professional | 54 · Surgery only | $1.26 | $3.63 | $5.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.25 Median $0.72 Typical High $1.02 | Professional | 55 · Aftercare only | $0.25 | $0.72 | $1.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.17 Median $0.49 Typical High $0.69 | Professional | 56 · Pre-op care only | $0.17 | $0.49 | $0.69 |
Where Tennessee sits
The same service costs 3.0 times more in Alaska than in Nebraska. 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
$7.59
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.