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 $53.70 Median $120.23 Typical High $169.82 | Professional | None | $53.70 | $120.23 | $169.82 |
Ambetter Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
BCBS Tennessee Setting Facility Modifier None Typical Low $524.81 Median $1,122.02 Typical High $2,570.40 | Facility | None | $524.81 | $1,122.02 | $2,570.40 |
BCBS Tennessee Setting Professional Modifier None Typical Low $77.62 Median $151.36 Typical High $288.40 | Professional | None | $77.62 | $151.36 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $912.01 Typical High $1,659.59 | Facility | None | $389.05 | $912.01 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $154.88 Typical High $263.03 | Professional | None | $72.44 | $154.88 | $263.03 |
Lucent Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,412.54 | Professional | None | $1,047.13 | $1,047.13 | $1,412.54 |
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 $66.07 Median $141.25 Typical High $295.12 | Professional | None | $66.07 | $141.25 | $295.12 |
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 $26.92 Median $42.66 Typical High $83.18 | Professional | 52 · Reduced service | $26.92 | $42.66 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $16.98 Typical High $33.11 | Professional | 53 · Discontinued | $10.72 | $16.98 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $64.57 Typical High $123.03 | Professional | 54 · Surgery only | $39.81 | $64.57 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $12.88 Typical High $24.55 | Professional | 55 · Aftercare only | $7.94 | $12.88 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $8.51 Typical High $16.60 | Professional | 56 · Pre-op care only | $5.37 | $8.51 | $16.60 |
Where Tennessee sits
The same service costs 4.9 times more in Alaska than in Hawaii. 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· 8th of 51
$224
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.