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 $47.86 Median $2,818.38 Typical High $7,585.78 | Facility | None | $47.86 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $190.55 Typical High $288.40 | Professional | None | $42.66 | $190.55 | $288.40 |
Ambetter Setting Professional Modifier None Typical Low $33.88 Median $89.13 Typical High $354.81 | Professional | None | $33.88 | $89.13 | $354.81 |
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 $51.29 Median $169.82 Typical High $346.74 | Professional | None | $51.29 | $169.82 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $138.04 Typical High $338.84 | Professional | None | $39.81 | $138.04 | $338.84 |
Lucent Health Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | None | $2,238.72 | $2,238.72 | $2,238.72 |
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 $43.65 Median $169.82 Typical High $407.38 | Professional | None | $43.65 | $169.82 | $407.38 |
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 $21.38 Median $77.62 Typical High $144.54 | Professional | 52 · Reduced service | $21.38 | $77.62 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $30.90 Typical High $57.54 | Professional | 53 · Discontinued | $8.51 | $30.90 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $23.44 Typical High $42.66 | Professional | 55 · Aftercare only | $6.46 | $23.44 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $15.49 Typical High $28.84 | Professional | 56 · Pre-op care only | $4.27 | $15.49 | $28.84 |
Where Tennessee sits
The same service costs 5.2 times more in North Carolina 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· 21st of 51
$191
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.