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 $891.25 Median $2,290.87 Typical High $7,585.78 | Facility | None | $891.25 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $1,698.24 Typical High $3,090.30 | Professional | None | $144.54 | $1,698.24 | $3,090.30 |
Ambetter Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
BCBS Tennessee Setting Facility Modifier None Typical Low $50.12 Median $125.89 Typical High $208.93 | Facility | None | $50.12 | $125.89 | $208.93 |
BCBS Tennessee Setting Professional Modifier None Typical Low $177.83 Median $524.81 Typical High $3,630.78 | Professional | None | $177.83 | $524.81 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,148.15 Typical High $2,691.53 | Facility | None | $562.34 | $1,148.15 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $467.74 Typical High $3,090.30 | Professional | None | $134.90 | $467.74 | $3,090.30 |
Lucent Health Setting Professional Modifier None Typical Low $11,481.54 Median $14,454.40 Typical High $14,454.40 | Professional | None | $11,481.54 | $14,454.40 | $14,454.40 |
United Setting Facility Modifier None Typical Low $1,778.28 Median $6,025.60 Typical High $13,489.63 | Facility | None | $1,778.28 | $6,025.60 | $13,489.63 |
United Setting Professional Modifier None Typical Low $165.96 Median $1,348.96 Typical High $3,311.31 | Professional | None | $165.96 | $1,348.96 | $3,311.31 |
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 $72.44 Median $134.90 Typical High $1,548.82 | Professional | 52 · Reduced service | $72.44 | $134.90 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $53.70 Typical High $616.60 | Professional | 53 · Discontinued | $28.84 | $53.70 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $199.53 Typical High $2,290.87 | Professional | 54 · Surgery only | $109.65 | $199.53 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $39.81 Typical High $457.09 | Professional | 55 · Aftercare only | $21.88 | $39.81 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $26.92 Typical High $309.03 | Professional | 56 · Pre-op care only | $14.45 | $26.92 | $309.03 |
Where Tennessee sits
The same service costs 11.2 times more in Oklahoma 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· 37th of 51
$1,585
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.