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 $741.31 Median $2,818.38 Typical High $6,606.93 | Facility | None | $741.31 | $2,818.38 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $1,737.80 Typical High $3,235.94 | Professional | None | $338.84 | $1,737.80 | $3,235.94 |
Ambetter Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $331.13 | Professional | None | $138.04 | $138.04 | $331.13 |
BCBS Tennessee Setting Facility Modifier None Typical Low $3,019.95 Median $6,165.95 Typical High $9,549.93 | Facility | None | $3,019.95 | $6,165.95 | $9,549.93 |
BCBS Tennessee Setting Professional Modifier None Typical Low $407.38 Median $1,621.81 Typical High $3,388.44 | Professional | None | $407.38 | $1,621.81 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $1,096.48 Typical High $3,162.28 | Professional | None | $323.59 | $1,096.48 | $3,162.28 |
Lucent Health Setting Professional Modifier None Typical Low $13,803.84 Median $19,952.62 Typical High $19,952.62 | Professional | None | $13,803.84 | $19,952.62 | $19,952.62 |
United Setting Facility Modifier None Typical Low $4,365.16 Median $7,943.28 Typical High $11,481.54 | Facility | None | $4,365.16 | $7,943.28 | $11,481.54 |
United Setting Professional Modifier None Typical Low $338.84 Median $1,621.81 Typical High $3,715.35 | Professional | None | $338.84 | $1,621.81 | $3,715.35 |
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 $169.82 Median $776.25 Typical High $1,621.81 | Professional | 52 · Reduced service | $169.82 | $776.25 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $316.23 Typical High $660.69 | Professional | 53 · Discontinued | $67.61 | $316.23 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $1,174.90 Typical High $2,454.71 | Professional | 54 · Surgery only | $257.04 | $1,174.90 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $234.42 Typical High $489.78 | Professional | 55 · Aftercare only | $51.29 | $234.42 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $158.49 Typical High $323.59 | Professional | 56 · Pre-op care only | $33.88 | $158.49 | $323.59 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $204.17 Median $1,000.00 Typical High $2,884.03 | Professional | 50 · Both sides | $204.17 | $1,000.00 | $2,884.03 |
Where Tennessee sits
The same service costs 6.2 times more in Washington 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· 17th of 51
$1,995
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.