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 $457.09 Median $2,290.87 Typical High $6,606.93 | Facility | None | $457.09 | $2,290.87 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $831.76 Typical High $1,412.54 | Professional | None | $245.47 | $831.76 | $1,412.54 |
Ambetter Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $190.55 | Professional | None | $138.04 | $138.04 | $190.55 |
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 $302.00 Median $812.83 Typical High $1,659.59 | Professional | None | $302.00 | $812.83 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $630.96 Typical High $1,548.82 | Professional | None | $223.87 | $630.96 | $1,548.82 |
Lucent Health Setting Professional Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $7,585.78 | Professional | None | $7,585.78 | $7,585.78 | $7,585.78 |
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 $251.19 Median $707.95 Typical High $1,778.28 | Professional | None | $251.19 | $707.95 | $1,778.28 |
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 $123.03 Median $346.74 Typical High $691.83 | Professional | 52 · Reduced service | $123.03 | $346.74 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $141.25 Typical High $275.42 | Professional | 53 · Discontinued | $48.98 | $141.25 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $524.81 Typical High $1,047.13 | Professional | 54 · Surgery only | $181.97 | $524.81 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $104.71 Typical High $208.93 | Professional | 55 · Aftercare only | $36.31 | $104.71 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $69.18 Typical High $138.04 | Professional | 56 · Pre-op care only | $24.55 | $69.18 | $138.04 |
Where Tennessee sits
The same service costs 4.3 times more in Wisconsin than in Hawaii. 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· 29th of 51
$776
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.