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 $575.44 Median $2,290.87 Typical High $7,585.78 | Facility | None | $575.44 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $269.15 Typical High $467.74 | Professional | None | $46.77 | $269.15 | $467.74 |
Ambetter Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $245.47 | Professional | None | $22.39 | $22.39 | $245.47 |
BCBS Tennessee Setting Facility Modifier None Typical Low $104.71 Median $147.91 Typical High $1,584.89 | Facility | None | $104.71 | $147.91 | $1,584.89 |
BCBS Tennessee Setting Professional Modifier None Typical Low $56.23 Median $245.47 Typical High $562.34 | Professional | None | $56.23 | $245.47 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $151.36 Typical High $501.19 | Professional | None | $42.66 | $151.36 | $501.19 |
Lucent Health Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,398.83 | $2,398.83 | $2,398.83 |
United Setting Facility Modifier None Typical Low $302.00 Median $724.44 Typical High $2,570.40 | Facility | None | $302.00 | $724.44 | $2,570.40 |
United Setting Professional Modifier None Typical Low $46.77 Median $263.03 Typical High $562.34 | Professional | None | $46.77 | $263.03 | $562.34 |
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 $23.44 Median $114.82 Typical High $229.09 | Professional | 52 · Reduced service | $23.44 | $114.82 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $45.71 Typical High $91.20 | Professional | 53 · Discontinued | $9.33 | $45.71 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $169.82 Typical High $338.84 | Professional | 54 · Surgery only | $35.48 | $169.82 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $33.88 Typical High $67.61 | Professional | 55 · Aftercare only | $7.08 | $33.88 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $22.91 Typical High $45.71 | Professional | 56 · Pre-op care only | $4.68 | $22.91 | $45.71 |
Where Tennessee sits
The same service costs 4.9 times more in Iowa than in Nebraska. 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· 22nd of 51
$275
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.