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 $69.18 Median $1,778.28 Typical High $6,606.93 | Facility | None | $69.18 | $1,778.28 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $69.18 Typical High $123.03 | Professional | None | $29.51 | $69.18 | $123.03 |
Ambetter Setting Professional Modifier None Typical Low $28.18 Median $75.86 Typical High $83.18 | Professional | None | $28.18 | $75.86 | $83.18 |
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 $38.02 Median $72.44 Typical High $120.23 | Professional | None | $38.02 | $72.44 | $120.23 |
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 $30.90 Median $66.07 Typical High $120.23 | Professional | None | $30.90 | $66.07 | $120.23 |
Lucent Health Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $776.25 | Professional | None | $602.56 | $602.56 | $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 $35.48 Median $69.18 Typical High $128.82 | Professional | None | $35.48 | $69.18 | $128.82 |
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 $14.13 Median $22.39 Typical High $46.77 | Professional | 52 · Reduced service | $14.13 | $22.39 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $8.91 Typical High $18.62 | Professional | 53 · Discontinued | $5.62 | $8.91 | $18.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $21.38 Median $33.11 Typical High $70.79 | Professional | 54 · Surgery only | $21.38 | $33.11 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $6.61 Typical High $14.13 | Professional | 55 · Aftercare only | $4.27 | $6.61 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $4.47 Typical High $9.33 | Professional | 56 · Pre-op care only | $2.82 | $4.47 | $9.33 |
Where Tennessee sits
The same service costs 3.7 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· 15th of 51
$93.33
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.