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 $112.20 Median $1,949.84 Typical High $6,606.93 | Facility | None | $112.20 | $1,949.84 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $85.11 Typical High $131.83 | Professional | None | $56.23 | $85.11 | $131.83 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
BCBS Tennessee Setting Facility Modifier None Typical Low $575.44 Median $1,148.15 Typical High $2,754.23 | Facility | None | $575.44 | $1,148.15 | $2,754.23 |
BCBS Tennessee Setting Professional Modifier None Typical Low $77.62 Median $109.65 Typical High $194.98 | Professional | None | $77.62 | $109.65 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $131.83 Typical High $1,659.59 | Facility | None | $66.07 | $131.83 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $95.50 Typical High $177.83 | Professional | None | $60.26 | $95.50 | $177.83 |
Lucent Health Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $912.01 | Professional | None | $758.58 | $758.58 | $912.01 |
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 $64.57 Median $107.15 Typical High $186.21 | Professional | None | $64.57 | $107.15 | $186.21 |
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 $28.18 Median $42.66 Typical High $60.26 | Professional | 52 · Reduced service | $28.18 | $42.66 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $16.98 Typical High $24.55 | Professional | 53 · Discontinued | $11.22 | $16.98 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $64.57 Typical High $91.20 | Professional | 54 · Surgery only | $41.69 | $64.57 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $12.88 Typical High $18.20 | Professional | 55 · Aftercare only | $8.32 | $12.88 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $8.51 Typical High $12.02 | Professional | 56 · Pre-op care only | $5.62 | $8.51 | $12.02 |
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· 15th of 51
$135
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.