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 $48.98 Median $93.33 Typical High $138.04 | Professional | None | $48.98 | $93.33 | $138.04 |
Ambetter Setting Professional Modifier None Typical Low $60.26 Median $100.00 Typical High $239.88 | Professional | None | $60.26 | $100.00 | $239.88 |
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 $58.88 Median $100.00 Typical High $194.98 | Professional | None | $58.88 | $100.00 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $151.36 Typical High $1,659.59 | Facility | None | $77.62 | $151.36 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $89.13 Typical High $162.18 | Professional | None | $47.86 | $89.13 | $162.18 |
Lucent Health Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $870.96 | Professional | None | $724.44 | $724.44 | $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 $51.29 Median $100.00 Typical High $190.55 | Professional | None | $51.29 | $100.00 | $190.55 |
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 $24.55 Median $46.77 Typical High $64.57 | Professional | 52 · Reduced service | $24.55 | $46.77 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $18.62 Typical High $25.70 | Professional | 53 · Discontinued | $10.00 | $18.62 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $69.18 Typical High $95.50 | Professional | 54 · Surgery only | $37.15 | $69.18 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $13.80 Typical High $19.05 | Professional | 55 · Aftercare only | $7.41 | $13.80 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $9.33 Typical High $12.88 | Professional | 56 · Pre-op care only | $4.90 | $9.33 | $12.88 |
Where Tennessee sits
The same service costs 2.8 times more in Wisconsin than in Kentucky. 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· 13th 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.