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 $602.56 Median $1,949.84 Typical High $6,606.93 | Facility | None | $602.56 | $1,949.84 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $1,202.26 Typical High $2,137.96 | Professional | None | $229.09 | $1,202.26 | $2,137.96 |
Ambetter Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
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 $275.42 Median $1,148.15 Typical High $2,344.23 | Professional | None | $275.42 | $1,148.15 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $741.31 Typical High $2,137.96 | Professional | None | $218.78 | $741.31 | $2,137.96 |
Lucent Health Setting Professional Modifier None Typical Low $9,120.11 Median $13,489.63 Typical High $13,489.63 | Professional | None | $9,120.11 | $13,489.63 | $13,489.63 |
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 $234.42 Median $1,096.48 Typical High $2,511.89 | Professional | None | $234.42 | $1,096.48 | $2,511.89 |
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 $114.82 Median $562.34 Typical High $1,071.52 | Professional | 52 · Reduced service | $114.82 | $562.34 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $223.87 Typical High $426.58 | Professional | 53 · Discontinued | $45.71 | $223.87 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $831.76 Typical High $1,621.81 | Professional | 54 · Surgery only | $173.78 | $831.76 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $165.96 Typical High $323.59 | Professional | 55 · Aftercare only | $34.67 | $165.96 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $112.20 Typical High $213.80 | Professional | 56 · Pre-op care only | $22.91 | $112.20 | $213.80 |
Where Tennessee sits
The same service costs 6.5 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· 22nd of 51
$1,230
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.