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 $794.33 Median $2,290.87 Typical High $7,585.78 | Facility | None | $794.33 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $371.54 Typical High $575.44 | Professional | None | $64.57 | $371.54 | $575.44 |
Ambetter Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $66.07 | Professional | None | $52.48 | $52.48 | $66.07 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,737.80 Median $3,890.45 Typical High $5,888.44 | Facility | None | $1,737.80 | $3,890.45 | $5,888.44 |
BCBS Tennessee Setting Professional Modifier None Typical Low $81.28 Median $288.40 Typical High $676.08 | Professional | None | $81.28 | $288.40 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $257.04 Typical High $660.69 | Professional | None | $75.86 | $257.04 | $660.69 |
Lucent Health Setting Professional Modifier None Typical Low $2,884.03 Median $3,467.37 Typical High $3,467.37 | Professional | None | $2,884.03 | $3,467.37 | $3,467.37 |
United Setting Facility Modifier None Typical Low $3,090.30 Median $4,677.35 Typical High $7,244.36 | Facility | None | $3,090.30 | $4,677.35 | $7,244.36 |
United Setting Professional Modifier None Typical Low $70.79 Median $316.23 Typical High $741.31 | Professional | None | $70.79 | $316.23 | $741.31 |
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 $32.36 Median $102.33 Typical High $288.40 | Professional | 52 · Reduced service | $32.36 | $102.33 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $40.74 Typical High $114.82 | Professional | 53 · Discontinued | $12.88 | $40.74 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $154.88 Typical High $436.52 | Professional | 54 · Surgery only | $47.86 | $154.88 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $30.90 Typical High $87.10 | Professional | 55 · Aftercare only | $9.55 | $30.90 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $20.42 Typical High $57.54 | Professional | 56 · Pre-op care only | $6.46 | $20.42 | $57.54 |
Where Tennessee sits
The same service costs 5.6 times more in Wisconsin than in Maryland. 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· 17th of 51
$398
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.