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 $63.10 Median $128.82 Typical High $213.80 | Professional | None | $63.10 | $128.82 | $213.80 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $181.97 Typical High $269.15 | Professional | None | $125.89 | $181.97 | $269.15 |
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 $87.10 Median $151.36 Typical High $263.03 | Professional | None | $87.10 | $151.36 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $234.42 Typical High $1,659.59 | Facility | None | $120.23 | $234.42 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $141.25 Typical High $234.42 | Professional | None | $69.18 | $141.25 | $234.42 |
Lucent Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,318.26 | Professional | None | $1,071.52 | $1,071.52 | $1,318.26 |
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 $72.44 Median $141.25 Typical High $275.42 | Professional | None | $72.44 | $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 $31.62 Median $51.29 Typical High $91.20 | Professional | 52 · Reduced service | $31.62 | $51.29 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $20.42 Typical High $36.31 | Professional | 53 · Discontinued | $12.59 | $20.42 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $75.86 Typical High $138.04 | Professional | 54 · Surgery only | $47.86 | $75.86 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $15.14 Typical High $27.54 | Professional | 55 · Aftercare only | $9.55 | $15.14 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $10.23 Typical High $18.20 | Professional | 56 · Pre-op care only | $6.31 | $10.23 | $18.20 |
Where Tennessee sits
The same service costs 3.3 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· 10th of 51
$191
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.