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 $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $44.67 Typical High $61.66 | Professional | None | $41.69 | $44.67 | $61.66 |
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 $51.29 Median $69.18 Typical High $114.82 | Professional | None | $51.29 | $69.18 | $114.82 |
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 $51.29 Median $61.66 Typical High $107.15 | Professional | None | $51.29 | $61.66 | $107.15 |
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 $44.67 Median $69.18 Typical High $109.65 | Professional | None | $44.67 | $69.18 | $109.65 |
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 $20.89 Median $21.88 Typical High $30.20 | Professional | 52 · Reduced service | $20.89 | $21.88 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.91 Typical High $12.30 | Professional | 53 · Discontinued | $8.32 | $8.91 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.61 Typical High $9.12 | Professional | 55 · Aftercare only | $6.31 | $6.61 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.47 Typical High $6.17 | Professional | 56 · Pre-op care only | $4.17 | $4.47 | $6.17 |
Where Tennessee sits
The same service costs 4.7 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· 3rd of 51
$135
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.