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 $87.10 Median $1,445.44 Typical High $4,265.80 | Facility | None | $87.10 | $1,445.44 | $4,265.80 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $87.10 Typical High $141.25 | Professional | None | $43.65 | $87.10 | $141.25 |
Ambetter Setting Professional Modifier None Typical Low $38.02 Median $93.33 Typical High $151.36 | Professional | None | $38.02 | $93.33 | $151.36 |
BCBS Tennessee Setting Facility Modifier None Typical Low $489.78 Median $1,230.27 Typical High $3,630.78 | Facility | None | $489.78 | $1,230.27 | $3,630.78 |
BCBS Tennessee Setting Professional Modifier None Typical Low $60.26 Median $93.33 Typical High $165.96 | Professional | None | $60.26 | $93.33 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $1,659.59 | Facility | None | $50.12 | $66.07 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $97.72 Typical High $158.49 | Professional | None | $46.77 | $97.72 | $158.49 |
Lucent Health Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $912.01 | Professional | None | $776.25 | $776.25 | $912.01 |
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 $51.29 Median $91.20 Typical High $177.83 | Professional | None | $51.29 | $91.20 | $177.83 |
8 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 $21.88 Median $34.67 Typical High $63.10 | Professional | 52 · Reduced service | $21.88 | $34.67 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $13.80 Typical High $25.12 | Professional | 53 · Discontinued | $8.71 | $13.80 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $52.48 Typical High $93.33 | Professional | 54 · Surgery only | $33.11 | $52.48 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $10.47 Typical High $18.62 | Professional | 55 · Aftercare only | $6.61 | $10.47 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $6.92 Typical High $12.59 | Professional | 56 · Pre-op care only | $4.37 | $6.92 | $12.59 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $24.55 Median $48.98 Typical High $66.07 | Professional | 51 · Multiple procedures | $24.55 | $48.98 | $66.07 |
Ambetter Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $54.95 Typical High $83.18 | Professional | 53 · Discontinued | $43.65 | $54.95 | $83.18 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $41.69 Median $83.18 Typical High $131.83 | Professional | 59 · Distinct service | $41.69 | $83.18 | $131.83 |
Where Tennessee sits
The same service costs 3.2 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· 16th of 51
$115
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.