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 $707.95 Median $2,818.38 Typical High $7,585.78 | Facility | None | $707.95 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $354.81 Typical High $446.68 | Professional | None | $269.15 | $354.81 | $446.68 |
Ambetter Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,230.27 Median $2,570.40 Typical High $6,309.57 | Facility | None | $1,230.27 | $2,570.40 | $6,309.57 |
BCBS Tennessee Setting Professional Modifier None Typical Low $346.74 Median $467.74 Typical High $851.14 | Professional | None | $346.74 | $467.74 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,691.53 Typical High $5,011.87 | Facility | None | $602.56 | $2,691.53 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $398.11 Typical High $676.08 | Professional | None | $288.40 | $398.11 | $676.08 |
Lucent Health Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Professional | None | $4,786.30 | $4,786.30 | $4,786.30 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,801.89 Typical High $6,760.83 | Facility | None | $1,202.26 | $3,801.89 | $6,760.83 |
United Setting Professional Modifier None Typical Low $302.00 Median $489.78 Typical High $676.08 | Professional | None | $302.00 | $489.78 | $676.08 |
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 $131.83 Median $177.83 Typical High $208.93 | Professional | 52 · Reduced service | $131.83 | $177.83 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $70.79 Typical High $83.18 | Professional | 53 · Discontinued | $53.70 | $70.79 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $263.03 Typical High $309.03 | Professional | 54 · Surgery only | $199.53 | $263.03 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $52.48 Typical High $61.66 | Professional | 55 · Aftercare only | $39.81 | $52.48 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $35.48 Typical High $41.69 | Professional | 56 · Pre-op care only | $26.92 | $35.48 | $41.69 |
Where Tennessee sits
The same service costs 10.0 times more in Oklahoma 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· 6th of 51
$1,122
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.