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 $1,819.70 Typical High $6,606.93 | Facility | None | $575.44 | $1,819.70 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $549.54 Typical High $1,174.90 | Professional | None | $165.96 | $549.54 | $1,174.90 |
Ambetter Setting Professional Modifier None Typical Low $218.78 Median $588.84 Typical High $588.84 | Professional | None | $218.78 | $588.84 | $588.84 |
BCBS Tennessee Setting Facility Modifier None Typical Low $524.81 Median $1,122.02 Typical High $2,570.40 | Facility | None | $524.81 | $1,122.02 | $2,570.40 |
BCBS Tennessee Setting Professional Modifier None Typical Low $169.82 Median $588.84 Typical High $1,174.90 | Professional | None | $169.82 | $588.84 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $707.95 Typical High $1,258.93 | Facility | None | $512.86 | $707.95 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $501.19 Typical High $1,096.48 | Professional | None | $177.83 | $501.19 | $1,096.48 |
Lucent Health Setting Professional Modifier None Typical Low $4,786.30 Median $5,888.44 Typical High $5,888.44 | Professional | None | $4,786.30 | $5,888.44 | $5,888.44 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,445.44 Typical High $3,630.78 | Facility | None | $512.86 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $165.96 Median $549.54 Typical High $1,288.25 | Professional | None | $165.96 | $549.54 | $1,288.25 |
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 $83.18 Median $251.19 Typical High $588.84 | Professional | 52 · Reduced service | $83.18 | $251.19 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $100.00 Typical High $234.42 | Professional | 53 · Discontinued | $33.11 | $100.00 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $380.19 Typical High $891.25 | Professional | 54 · Surgery only | $123.03 | $380.19 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $75.86 Typical High $177.83 | Professional | 55 · Aftercare only | $24.55 | $75.86 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $50.12 Typical High $117.49 | Professional | 56 · Pre-op care only | $16.60 | $50.12 | $117.49 |
Where Tennessee sits
The same service costs 5.2 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· 13th of 51
$708
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.