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 $616.60 Median $2,290.87 Typical High $6,606.93 | Facility | None | $616.60 | $2,290.87 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $602.56 Typical High $1,000.00 | Professional | None | $134.90 | $602.56 | $1,000.00 |
Ambetter Setting Professional Modifier None Typical Low $144.54 Median $186.21 Typical High $794.33 | Professional | None | $144.54 | $186.21 | $794.33 |
BCBS Tennessee Setting Facility Modifier None Typical Low $104.71 Median $147.91 Typical High $3,801.89 | Facility | None | $104.71 | $147.91 | $3,801.89 |
BCBS Tennessee Setting Professional Modifier None Typical Low $162.18 Median $512.86 Typical High $1,071.52 | Professional | None | $162.18 | $512.86 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $416.87 Typical High $1,023.29 | Professional | None | $123.03 | $416.87 | $1,023.29 |
Lucent Health Setting Professional Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $4,897.79 | Professional | None | $4,168.69 | $4,168.69 | $4,897.79 |
United Setting Facility Modifier None Typical Low $302.00 Median $741.31 Typical High $2,570.40 | Facility | None | $302.00 | $741.31 | $2,570.40 |
United Setting Professional Modifier None Typical Low $141.25 Median $416.87 Typical High $1,174.90 | Professional | None | $141.25 | $416.87 | $1,174.90 |
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 $66.07 Median $208.93 Typical High $489.78 | Professional | 52 · Reduced service | $66.07 | $208.93 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $83.18 Typical High $194.98 | Professional | 53 · Discontinued | $26.92 | $83.18 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $309.03 Typical High $741.31 | Professional | 54 · Surgery only | $100.00 | $309.03 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $61.66 Typical High $147.91 | Professional | 55 · Aftercare only | $19.95 | $61.66 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $41.69 Typical High $97.72 | Professional | 56 · Pre-op care only | $13.49 | $41.69 | $97.72 |
Where Tennessee sits
The same service costs 3.8 times more in Wisconsin 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· 15th of 51
$603
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.