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 $281.84 Median $1,949.84 Typical High $6,606.93 | Facility | None | $281.84 | $1,949.84 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $223.87 Typical High $407.38 | Professional | None | $74.13 | $223.87 | $407.38 |
Ambetter Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
BCBS Tennessee Setting Facility Modifier None Typical Low $104.71 Median $147.91 Typical High $1,584.89 | Facility | None | $104.71 | $147.91 | $1,584.89 |
BCBS Tennessee Setting Professional Modifier None Typical Low $97.72 Median $251.19 Typical High $512.86 | Professional | None | $97.72 | $251.19 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $218.78 Typical High $489.78 | Professional | None | $75.86 | $218.78 | $489.78 |
Lucent Health Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,818.38 | $2,818.38 | $2,818.38 |
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 $81.28 Median $239.88 Typical High $562.34 | Professional | None | $81.28 | $239.88 | $562.34 |
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 $37.15 Median $104.71 Typical High $204.17 | Professional | 52 · Reduced service | $37.15 | $104.71 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $41.69 Typical High $81.28 | Professional | 53 · Discontinued | $14.79 | $41.69 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $154.88 Typical High $302.00 | Professional | 54 · Surgery only | $56.23 | $154.88 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $31.62 Typical High $60.26 | Professional | 55 · Aftercare only | $11.22 | $31.62 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $20.89 Typical High $40.74 | Professional | 56 · Pre-op care only | $7.41 | $20.89 | $40.74 |
Where Tennessee sits
The same service costs 4.2 times more in Washington 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
$282
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.