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 $812.83 Median $2,398.83 Typical High $7,585.78 | Facility | None | $812.83 | $2,398.83 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $229.09 Typical High $346.74 | Professional | None | $151.36 | $229.09 | $346.74 |
BCBS Tennessee Setting Facility Modifier None Typical Low $524.81 Median $1,122.02 Typical High $2,570.40 | Facility | None | $524.81 | $1,122.02 | $2,570.40 |
BCBS Tennessee Setting Professional Modifier None Typical Low $190.55 Median $302.00 Typical High $562.34 | Professional | None | $190.55 | $302.00 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $1,000.00 Typical High $1,819.70 | Facility | None | $389.05 | $1,000.00 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $239.88 Typical High $489.78 | Professional | None | $154.88 | $239.88 | $489.78 |
Lucent Health Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,621.81 Typical High $3,630.78 | Facility | None | $512.86 | $1,621.81 | $3,630.78 |
United Setting Professional Modifier None Typical Low $162.18 Median $302.00 Typical High $512.86 | Professional | None | $162.18 | $302.00 | $512.86 |
6 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 $72.44 Median $109.65 Typical High $151.36 | Professional | 52 · Reduced service | $72.44 | $109.65 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $43.65 Typical High $60.26 | Professional | 53 · Discontinued | $29.51 | $43.65 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $165.96 Typical High $229.09 | Professional | 54 · Surgery only | $109.65 | $165.96 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $33.11 Typical High $45.71 | Professional | 55 · Aftercare only | $21.88 | $33.11 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $21.88 Typical High $30.20 | Professional | 56 · Pre-op care only | $14.45 | $21.88 | $30.20 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | 50 · Both sides | $91.20 | $91.20 | $91.20 |
Where Tennessee sits
The same service costs 3.1 times more in Alaska than in New York. 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· 15th of 51
$380
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.