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 $467.74 Median $2,290.87 Typical High $7,585.78 | Facility | None | $467.74 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $69.18 Typical High $123.03 | Professional | None | $48.98 | $69.18 | $123.03 |
Ambetter Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $114.82 | Professional | None | $67.61 | $67.61 | $114.82 |
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 $61.66 Median $83.18 Typical High $123.03 | Professional | None | $61.66 | $83.18 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $91.20 Typical High $1,659.59 | Facility | None | $46.77 | $91.20 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $72.44 Typical High $141.25 | Professional | None | $47.86 | $72.44 | $141.25 |
Lucent Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
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 $50.12 Median $83.18 Typical High $151.36 | Professional | None | $50.12 | $83.18 | $151.36 |
6 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 $24.55 Median $33.88 Typical High $47.86 | Professional | 52 · Reduced service | $24.55 | $33.88 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $13.49 Typical High $19.05 | Professional | 53 · Discontinued | $9.77 | $13.49 | $19.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $51.29 Typical High $72.44 | Professional | 54 · Surgery only | $37.15 | $51.29 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $10.23 Typical High $14.45 | Professional | 55 · Aftercare only | $7.41 | $10.23 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $6.76 Typical High $9.55 | Professional | 56 · Pre-op care only | $4.90 | $6.76 | $9.55 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $72.44 Median $107.15 Typical High $199.53 | Professional | 50 · Both sides | $72.44 | $107.15 | $199.53 |
Where Tennessee sits
The same service costs 3.2 times more in Alaska than in Texas. 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· 27th of 51
$91.20
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.