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 $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $66.07 Typical High $93.33 | Professional | None | $63.10 | $66.07 | $93.33 |
BCBS Tennessee Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $1,905.46 | Facility | None | $407.38 | $812.83 | $1,905.46 |
BCBS Tennessee Setting Professional Modifier None Typical Low $77.62 Median $104.71 Typical High $173.78 | Professional | None | $77.62 | $104.71 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $954.99 Typical High $1,659.59 | Facility | None | $380.19 | $954.99 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $93.33 Typical High $154.88 | Professional | None | $77.62 | $93.33 | $154.88 |
Lucent Health Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
United Setting Facility Modifier None Typical Low $107.15 Median $436.52 Typical High $1,778.28 | Facility | None | $107.15 | $436.52 | $1,778.28 |
United Setting Professional Modifier None Typical Low $67.61 Median $102.33 Typical High $165.96 | Professional | None | $67.61 | $102.33 | $165.96 |
4 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 $31.62 Median $33.11 Typical High $45.71 | Professional | 52 · Reduced service | $31.62 | $33.11 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $13.49 Typical High $18.62 | Professional | 53 · Discontinued | $12.59 | $13.49 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $10.00 Typical High $13.80 | Professional | 55 · Aftercare only | $9.55 | $10.00 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.61 Typical High $9.33 | Professional | 56 · Pre-op care only | $6.31 | $6.61 | $9.33 |
Where Tennessee sits
The same service costs 4.5 times more in Wisconsin than in Kentucky. 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· 5th of 51
$174
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.