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 $72.44 Median $72.44 Typical High $107.15 | Facility | None | $72.44 | $72.44 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $104.71 Typical High $151.36 | Professional | None | $72.44 | $104.71 | $151.36 |
BCBS Tennessee Setting Facility Modifier None Typical Low $398.11 Median $741.31 Typical High $1,862.09 | Facility | None | $398.11 | $741.31 | $1,862.09 |
BCBS Tennessee Setting Professional Modifier None Typical Low $95.50 Median $147.91 Typical High $275.42 | Professional | None | $95.50 | $147.91 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $100.00 Typical High $186.21 | Facility | None | $50.12 | $100.00 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $114.82 Typical High $186.21 | Professional | None | $74.13 | $114.82 | $186.21 |
Lucent Health Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,174.90 | Professional | None | $912.01 | $912.01 | $1,174.90 |
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 $75.86 Median $114.82 Typical High $213.80 | Professional | None | $75.86 | $114.82 | $213.80 |
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 $36.31 Median $52.48 Typical High $75.86 | Professional | 52 · Reduced service | $36.31 | $52.48 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $20.89 Typical High $30.20 | Professional | 53 · Discontinued | $14.45 | $20.89 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $15.85 Typical High $22.91 | Professional | 55 · Aftercare only | $10.96 | $15.85 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $10.47 Typical High $15.14 | Professional | 56 · Pre-op care only | $7.24 | $10.47 | $15.14 |
Where Tennessee sits
The same service costs 3.5 times more in Alaska than in Maryland. 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
$145
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.