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 $85.11 Median $1,348.96 Typical High $4,265.80 | Facility | None | $85.11 | $1,348.96 | $4,265.80 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $85.11 Typical High $117.49 | Professional | None | $42.66 | $85.11 | $117.49 |
Ambetter Setting Professional Modifier None Typical Low $48.98 Median $109.65 Typical High $109.65 | Professional | None | $48.98 | $109.65 | $109.65 |
BCBS Tennessee Setting Facility Modifier None Typical Low $758.58 Median $1,479.11 Typical High $2,290.87 | Facility | None | $758.58 | $1,479.11 | $2,290.87 |
BCBS Tennessee Setting Professional Modifier None Typical Low $44.67 Median $91.20 Typical High $154.88 | Professional | None | $44.67 | $91.20 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $81.28 Typical High $147.91 | Professional | None | $39.81 | $81.28 | $147.91 |
Lucent Health Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
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 $42.66 Median $85.11 Typical High $165.96 | Professional | None | $42.66 | $85.11 | $165.96 |
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 $20.89 Median $42.66 Typical High $58.88 | Professional | 52 · Reduced service | $20.89 | $42.66 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $16.98 Typical High $23.44 | Professional | 53 · Discontinued | $8.51 | $16.98 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $63.10 Typical High $87.10 | Professional | 54 · Surgery only | $31.62 | $63.10 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $12.59 Typical High $17.38 | Professional | 55 · Aftercare only | $6.31 | $12.59 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $8.51 Typical High $11.75 | Professional | 56 · Pre-op care only | $4.27 | $8.51 | $11.75 |
Where Tennessee sits
The same service costs 2.5 times more in North Carolina 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· 34th of 51
$89.13
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.