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 $66.07 Median $109.65 Typical High $151.36 | Professional | None | $66.07 | $109.65 | $151.36 |
Ambetter Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
BCBS Tennessee Setting Facility Modifier None Typical Low $104.71 Median $147.91 Typical High $1,584.89 | Facility | None | $104.71 | $147.91 | $1,584.89 |
BCBS Tennessee Setting Professional Modifier None Typical Low $81.28 Median $117.49 Typical High $208.93 | Professional | None | $81.28 | $117.49 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $109.65 Typical High $213.80 | Professional | None | $64.57 | $109.65 | $213.80 |
Lucent Health Setting Professional Modifier None Typical Low $2,238.72 Median $3,715.35 Typical High $3,715.35 | Professional | None | $2,238.72 | $3,715.35 | $3,715.35 |
United Setting Facility Modifier None Typical Low $302.00 Median $741.31 Typical High $2,570.40 | Facility | None | $302.00 | $741.31 | $2,570.40 |
United Setting Professional Modifier None Typical Low $69.18 Median $114.82 Typical High $257.04 | Professional | None | $69.18 | $114.82 | $257.04 |
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 $33.11 Median $54.95 Typical High $75.86 | Professional | 52 · Reduced service | $33.11 | $54.95 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $21.88 Typical High $30.90 | Professional | 53 · Discontinued | $13.49 | $21.88 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $83.18 Typical High $114.82 | Professional | 54 · Surgery only | $50.12 | $83.18 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $16.60 Typical High $22.91 | Professional | 55 · Aftercare only | $10.00 | $16.60 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $10.96 Typical High $15.14 | Professional | 56 · Pre-op care only | $6.61 | $10.96 | $15.14 |
Where Tennessee sits
The same service costs 3.2 times more in Alaska than in Florida. 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
$129
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.