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 $1,071.52 Median $2,454.71 Typical High $7,585.78 | Facility | None | $1,071.52 | $2,454.71 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $173.78 Typical High $269.15 | Professional | None | $109.65 | $173.78 | $269.15 |
Ambetter Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
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 $134.90 Median $208.93 Typical High $389.05 | Professional | None | $134.90 | $208.93 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $281.84 Typical High $1,659.59 | Facility | None | $144.54 | $281.84 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $181.97 Typical High $354.81 | Professional | None | $109.65 | $181.97 | $354.81 |
Lucent Health Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
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 $117.49 Median $218.78 Typical High $389.05 | Professional | None | $117.49 | $218.78 | $389.05 |
5 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 $52.48 Median $87.10 Typical High $117.49 | Professional | 52 · Reduced service | $52.48 | $87.10 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $34.67 Typical High $47.86 | Professional | 53 · Discontinued | $20.89 | $34.67 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $128.82 Typical High $177.83 | Professional | 54 · Surgery only | $77.62 | $128.82 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $25.70 Typical High $35.48 | Professional | 55 · Aftercare only | $15.49 | $25.70 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $17.38 Typical High $23.44 | Professional | 56 · Pre-op care only | $10.47 | $17.38 | $23.44 |
Where Tennessee sits
The same service costs 3.0 times more in Wisconsin 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
$251
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.