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 $53.70 Median $89.13 Typical High $165.96 | Professional | None | $53.70 | $89.13 | $165.96 |
Ambetter Setting Professional Modifier None Typical Low $69.18 Median $91.20 Typical High $169.82 | Professional | None | $69.18 | $91.20 | $169.82 |
BCBS Tennessee Setting Facility Modifier None Typical Low $371.54 Median $724.44 Typical High $1,862.09 | Facility | None | $371.54 | $724.44 | $1,862.09 |
BCBS Tennessee Setting Professional Modifier None Typical Low $89.13 Median $131.83 Typical High $218.78 | Professional | None | $89.13 | $131.83 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $162.18 | Facility | None | $50.12 | $66.07 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $100.00 Typical High $194.98 | Professional | None | $58.88 | $100.00 | $194.98 |
Lucent Health Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $851.14 | Professional | None | $724.44 | $724.44 | $851.14 |
United Setting Facility Modifier None Typical Low $107.15 Median $436.52 Typical High $1,778.28 | Facility | None | $107.15 | $436.52 | $1,778.28 |
United Setting Professional Modifier None Typical Low $67.61 Median $123.03 Typical High $194.98 | Professional | None | $67.61 | $123.03 | $194.98 |
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 $26.92 Median $42.66 Typical High $61.66 | Professional | 52 · Reduced service | $26.92 | $42.66 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $16.98 Typical High $24.55 | Professional | 53 · Discontinued | $10.96 | $16.98 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $63.10 Typical High $91.20 | Professional | 54 · Surgery only | $40.74 | $63.10 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $12.59 Typical High $18.20 | Professional | 55 · Aftercare only | $8.13 | $12.59 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $8.51 Typical High $12.30 | Professional | 56 · Pre-op care only | $5.37 | $8.51 | $12.30 |
Where Tennessee sits
The same service costs 3.0 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· 16th 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.