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 $36.31 Median $83.18 Typical High $162.18 | Professional | None | $36.31 | $83.18 | $162.18 |
Ambetter Setting Professional Modifier None Typical Low $138.04 Median $158.49 Typical High $269.15 | Professional | None | $138.04 | $158.49 | $269.15 |
BCBS Tennessee Setting Facility Modifier None Typical Low $371.54 Median $724.44 Typical High $1,862.09 | Facility | None | $371.54 | $724.44 | $1,862.09 |
BCBS Tennessee Setting Professional Modifier None Typical Low $38.90 Median $91.20 Typical High $147.91 | Professional | None | $38.90 | $91.20 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $1,659.59 | Facility | None | $50.12 | $66.07 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $85.11 Typical High $144.54 | Professional | None | $43.65 | $85.11 | $144.54 |
Lucent Health Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,122.02 | Professional | None | $812.83 | $812.83 | $1,122.02 |
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 $38.90 Median $81.28 Typical High $147.91 | Professional | None | $38.90 | $81.28 | $147.91 |
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 $18.20 Median $39.81 Typical High $81.28 | Professional | 52 · Reduced service | $18.20 | $39.81 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $15.85 Typical High $32.36 | Professional | 53 · Discontinued | $7.24 | $15.85 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $26.92 Median $60.26 Typical High $123.03 | Professional | 54 · Surgery only | $26.92 | $60.26 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $12.30 Typical High $24.55 | Professional | 55 · Aftercare only | $5.37 | $12.30 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $8.13 Typical High $16.22 | Professional | 56 · Pre-op care only | $3.63 | $8.13 | $16.22 |
Where Tennessee sits
The same service costs 3.4 times more in Alaska than in Washington, DC. 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· 22nd of 51
$102
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.