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 $93.33 Median $93.33 Typical High $125.89 | Facility | None | $93.33 | $93.33 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $125.89 Typical High $177.83 | Professional | None | $93.33 | $125.89 | $177.83 |
BCBS Tennessee Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $1,905.46 | Facility | None | $407.38 | $812.83 | $1,905.46 |
BCBS Tennessee Setting Professional Modifier None Typical Low $120.23 Median $177.83 Typical High $323.59 | Professional | None | $120.23 | $177.83 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $114.82 Typical High $213.80 | Facility | None | $50.12 | $114.82 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $141.25 Typical High $229.09 | Professional | None | $97.72 | $141.25 | $229.09 |
Lucent Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,348.96 | Professional | None | $1,047.13 | $1,047.13 | $1,348.96 |
United Setting Facility Modifier None Typical Low $107.15 Median $436.52 Typical High $1,778.28 | Facility | None | $107.15 | $436.52 | $1,778.28 |
United Setting Professional Modifier None Typical Low $95.50 Median $138.04 Typical High $251.19 | Professional | None | $95.50 | $138.04 | $251.19 |
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 $46.77 Median $63.10 Typical High $89.13 | Professional | 52 · Reduced service | $46.77 | $63.10 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $25.12 Typical High $35.48 | Professional | 53 · Discontinued | $19.05 | $25.12 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $18.62 Typical High $26.30 | Professional | 55 · Aftercare only | $14.13 | $18.62 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $12.59 Typical High $17.78 | Professional | 56 · Pre-op care only | $9.33 | $12.59 | $17.78 |
Where Tennessee sits
The same service costs 4.0 times more in Alaska than in Florida. 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· 20th 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.