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 $89.13 Median $134.90 Typical High $138.04 | Facility | None | $89.13 | $134.90 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $89.13 Typical High $117.49 | Professional | None | $79.43 | $89.13 | $117.49 |
Ambetter Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,071.52 Median $2,137.96 Typical High $5,128.61 | Facility | None | $1,071.52 | $2,137.96 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $104.71 Median $138.04 Typical High $218.78 | Professional | None | $104.71 | $138.04 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $1,778.28 Typical High $3,801.89 | Facility | None | $389.05 | $1,778.28 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $120.23 Typical High $204.17 | Professional | None | $91.20 | $120.23 | $204.17 |
Lucent Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,570.40 Typical High $5,128.61 | Facility | None | $1,000.00 | $2,570.40 | $5,128.61 |
United Setting Professional Modifier None Typical Low $97.72 Median $138.04 Typical High $213.80 | Professional | None | $97.72 | $138.04 | $213.80 |
4 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 $39.81 Median $44.67 Typical High $45.71 | Professional | 52 · Reduced service | $39.81 | $44.67 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $17.78 Typical High $18.20 | Professional | 53 · Discontinued | $15.85 | $17.78 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $13.18 Typical High $13.80 | Professional | 55 · Aftercare only | $12.02 | $13.18 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.91 Typical High $9.12 | Professional | 56 · Pre-op care only | $7.94 | $8.91 | $9.12 |
Where Tennessee sits
The same service costs 7.9 times more in Kansas 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· 3rd of 51
$562
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.