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 $25.70 Median $25.70 Typical High $38.02 | Facility | None | $25.70 | $25.70 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $38.02 Typical High $53.70 | Professional | None | $25.70 | $38.02 | $53.70 |
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 $34.67 Median $54.95 Typical High $100.00 | Professional | None | $34.67 | $54.95 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $26.30 Median $50.12 Typical High $162.18 | Facility | None | $26.30 | $50.12 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $26.30 Median $40.74 Typical High $70.79 | Professional | None | $26.30 | $40.74 | $70.79 |
Lucent Health Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $371.54 | Professional | None | $323.59 | $323.59 | $371.54 |
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 $26.92 Median $42.66 Typical High $79.43 | Professional | None | $26.92 | $42.66 | $79.43 |
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 $12.88 Median $18.62 Typical High $26.92 | Professional | 52 · Reduced service | $12.88 | $18.62 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $7.59 Typical High $10.72 | Professional | 53 · Discontinued | $5.13 | $7.59 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $5.62 Typical High $8.13 | Professional | 55 · Aftercare only | $3.80 | $5.62 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $3.80 Typical High $5.37 | Professional | 56 · Pre-op care only | $2.57 | $3.80 | $5.37 |
Where Tennessee sits
The same service costs 3.3 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
$53.70
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.