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 $60.26 Median $131.83 Typical High $186.21 | Professional | None | $60.26 | $131.83 | $186.21 |
Ambetter Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
BCBS Tennessee Setting Facility Modifier None Typical Low $100.00 Median $138.04 Typical High $501.19 | Facility | None | $100.00 | $138.04 | $501.19 |
BCBS Tennessee Setting Professional Modifier None Typical Low $89.13 Median $169.82 Typical High $302.00 | Professional | None | $89.13 | $169.82 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $162.18 Typical High $275.42 | Professional | None | $81.28 | $162.18 | $275.42 |
Lucent Health Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
United Setting Facility Modifier None Typical Low $302.00 Median $741.31 Typical High $2,570.40 | Facility | None | $302.00 | $741.31 | $2,570.40 |
United Setting Professional Modifier None Typical Low $75.86 Median $158.49 Typical High $323.59 | Professional | None | $75.86 | $158.49 | $323.59 |
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 $30.20 Median $64.57 Typical High $91.20 | Professional | 52 · Reduced service | $30.20 | $64.57 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $25.70 Typical High $36.31 | Professional | 53 · Discontinued | $12.02 | $25.70 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $95.50 Typical High $134.90 | Professional | 54 · Surgery only | $45.71 | $95.50 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $19.50 Typical High $26.92 | Professional | 55 · Aftercare only | $9.12 | $19.50 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $12.88 Typical High $18.20 | Professional | 56 · Pre-op care only | $6.03 | $12.88 | $18.20 |
Where Tennessee sits
The same service costs 2.6 times more in Wisconsin than in Utah. 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
$170
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.