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 $34.67 Median $56.23 Typical High $85.11 | Facility | None | $34.67 | $56.23 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $34.67 Median $56.23 Typical High $95.50 | Professional | None | $34.67 | $56.23 | $95.50 |
Ambetter Setting Professional Modifier None Typical Low $58.88 Median $72.44 Typical High $134.90 | Professional | None | $58.88 | $72.44 | $134.90 |
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 $45.71 Median $77.62 Typical High $147.91 | Professional | None | $45.71 | $77.62 | $147.91 |
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 $37.15 Median $61.66 Typical High $100.00 | Professional | None | $37.15 | $61.66 | $100.00 |
Lucent Health Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $691.83 | Professional | None | $501.19 | $501.19 | $691.83 |
United Setting Facility Modifier None Typical Low $107.15 Median $436.52 Typical High $1,737.80 | Facility | None | $107.15 | $436.52 | $1,737.80 |
United Setting Professional Modifier None Typical Low $36.31 Median $58.88 Typical High $112.20 | Professional | None | $36.31 | $58.88 | $112.20 |
4 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 $17.38 Median $28.18 Typical High $39.81 | Professional | 52 · Reduced service | $17.38 | $28.18 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $11.22 Typical High $16.22 | Professional | 53 · Discontinued | $6.92 | $11.22 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $8.32 Typical High $12.02 | Professional | 55 · Aftercare only | $5.25 | $8.32 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $5.62 Typical High $7.94 | Professional | 56 · Pre-op care only | $3.47 | $5.62 | $7.94 |
Where Tennessee sits
The same service costs 4.0 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· 18th of 51
$75.86
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.