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 $66.07 Median $162.18 Typical High $251.19 | Professional | None | $66.07 | $162.18 | $251.19 |
Ambetter Setting Professional Modifier None Typical Low $93.33 Median $199.53 Typical High $269.15 | Professional | None | $93.33 | $199.53 | $269.15 |
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 $177.83 Typical High $331.13 | Professional | None | $89.13 | $177.83 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $173.78 Typical High $323.59 | Professional | None | $67.61 | $173.78 | $323.59 |
Lucent Health Setting Professional Modifier None Typical Low $1,698.24 Median $2,630.27 Typical High $2,630.27 | Professional | None | $1,698.24 | $2,630.27 | $2,630.27 |
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 $72.44 Median $169.82 Typical High $398.11 | Professional | None | $72.44 | $169.82 | $398.11 |
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 $33.11 Median $75.86 Typical High $125.89 | Professional | 52 · Reduced service | $33.11 | $75.86 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $30.90 Typical High $50.12 | Professional | 53 · Discontinued | $13.18 | $30.90 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $114.82 Typical High $190.55 | Professional | 54 · Surgery only | $50.12 | $114.82 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $22.91 Typical High $38.02 | Professional | 55 · Aftercare only | $10.00 | $22.91 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $15.14 Typical High $25.12 | Professional | 56 · Pre-op care only | $6.61 | $15.14 | $25.12 |
Where Tennessee sits
The same service costs 3.8 times more in Alaska than in Virginia. 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· 18th of 51
$186
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.