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 $75.86 Median $128.82 Typical High $177.83 | Professional | None | $75.86 | $128.82 | $177.83 |
Ambetter Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
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 $91.20 Median $144.54 Typical High $269.15 | Professional | None | $91.20 | $144.54 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $436.52 Typical High $1,659.59 | Facility | None | $338.84 | $436.52 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $125.89 Typical High $251.19 | Professional | None | $74.13 | $125.89 | $251.19 |
Lucent Health Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
United Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $2,511.89 | Facility | None | $346.74 | $1,047.13 | $2,511.89 |
United Setting Professional Modifier None Typical Low $77.62 Median $141.25 Typical High $275.42 | Professional | None | $77.62 | $141.25 | $275.42 |
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 $38.02 Median $64.57 Typical High $89.13 | Professional | 52 · Reduced service | $38.02 | $64.57 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $26.30 Typical High $36.31 | Professional | 53 · Discontinued | $15.14 | $26.30 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $97.72 Typical High $134.90 | Professional | 54 · Surgery only | $57.54 | $97.72 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $19.50 Typical High $26.92 | Professional | 55 · Aftercare only | $11.48 | $19.50 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $12.88 Typical High $17.78 | Professional | 56 · Pre-op care only | $7.59 | $12.88 | $17.78 |
Where Tennessee sits
The same service costs 3.6 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
$195
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.