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 $436.52 Median $2,290.87 Typical High $6,606.93 | Facility | None | $436.52 | $2,290.87 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $331.13 Typical High $512.86 | Professional | None | $239.88 | $331.13 | $512.86 |
Ambetter Setting Professional Modifier None Typical Low $257.04 Median $275.42 Typical High $363.08 | Professional | None | $257.04 | $275.42 | $363.08 |
BCBS Tennessee Setting Facility Modifier None Typical Low $977.24 Median $2,398.83 Typical High $6,309.57 | Facility | None | $977.24 | $2,398.83 | $6,309.57 |
BCBS Tennessee Setting Professional Modifier None Typical Low $331.13 Median $489.78 Typical High $812.83 | Professional | None | $331.13 | $489.78 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $2,344.23 Typical High $5,011.87 | Facility | None | $524.81 | $2,344.23 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $407.38 Typical High $812.83 | Professional | None | $263.03 | $407.38 | $812.83 |
Lucent Health Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Professional | None | $4,897.79 | $4,897.79 | $4,897.79 |
United Setting Facility Modifier None Typical Low $346.74 Median $1,071.52 Typical High $7,079.46 | Facility | None | $346.74 | $1,071.52 | $7,079.46 |
United Setting Professional Modifier None Typical Low $275.42 Median $489.78 Typical High $794.33 | Professional | None | $275.42 | $489.78 | $794.33 |
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 $120.23 Median $165.96 Typical High $234.42 | Professional | 52 · Reduced service | $120.23 | $165.96 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $66.07 Typical High $93.33 | Professional | 53 · Discontinued | $48.98 | $66.07 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $251.19 Typical High $354.81 | Professional | 54 · Surgery only | $181.97 | $251.19 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $50.12 Typical High $70.79 | Professional | 55 · Aftercare only | $36.31 | $50.12 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $33.11 Typical High $46.77 | Professional | 56 · Pre-op care only | $23.99 | $33.11 | $46.77 |
Where Tennessee sits
The same service costs 3.9 times more in Alaska than in New York. 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
$537
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.