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 $602.56 Median $2,290.87 Typical High $7,585.78 | Facility | None | $602.56 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $91.20 Typical High $141.25 | Professional | None | $25.12 | $91.20 | $141.25 |
Ambetter Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
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 $34.67 Median $91.20 Typical High $213.80 | Professional | None | $34.67 | $91.20 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $107.15 Typical High $199.53 | Facility | None | $50.12 | $107.15 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $85.11 Typical High $165.96 | Professional | None | $26.92 | $85.11 | $165.96 |
Lucent Health Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $870.96 | Professional | None | $851.14 | $851.14 | $870.96 |
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 $30.20 Median $89.13 Typical High $199.53 | Professional | None | $30.20 | $89.13 | $199.53 |
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 $12.59 Median $30.20 Typical High $69.18 | Professional | 52 · Reduced service | $12.59 | $30.20 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $12.02 Typical High $27.54 | Professional | 53 · Discontinued | $5.13 | $12.02 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.05 Median $44.67 Typical High $102.33 | Professional | 54 · Surgery only | $19.05 | $44.67 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $8.91 Typical High $20.42 | Professional | 55 · Aftercare only | $3.80 | $8.91 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $6.03 Typical High $13.80 | Professional | 56 · Pre-op care only | $2.51 | $6.03 | $13.80 |
Where Tennessee sits
The same service costs 5.4 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· 11th of 51
$126
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.