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 $52.48 Median $107.15 Typical High $147.91 | Professional | None | $52.48 | $107.15 | $147.91 |
Ambetter Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $288.40 | Professional | None | $112.20 | $112.20 | $288.40 |
BCBS Tennessee Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $1,905.46 | Facility | None | $407.38 | $812.83 | $1,905.46 |
BCBS Tennessee Setting Professional Modifier None Typical Low $66.07 Median $114.82 Typical High $177.83 | Professional | None | $66.07 | $114.82 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $190.55 Typical High $1,659.59 | Facility | None | $97.72 | $190.55 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $114.82 Typical High $186.21 | Professional | None | $50.12 | $114.82 | $186.21 |
Lucent Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
United Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $2,511.89 | Facility | None | $346.74 | $1,047.13 | $2,511.89 |
United Setting Professional Modifier None Typical Low $53.70 Median $109.65 Typical High $208.93 | Professional | None | $53.70 | $109.65 | $208.93 |
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 $26.30 Median $51.29 Typical High $74.13 | Professional | 52 · Reduced service | $26.30 | $51.29 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $20.42 Typical High $30.20 | Professional | 53 · Discontinued | $10.47 | $20.42 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $75.86 Typical High $112.20 | Professional | 54 · Surgery only | $38.90 | $75.86 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $15.14 Typical High $22.39 | Professional | 55 · Aftercare only | $7.76 | $15.14 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $10.23 Typical High $14.79 | Professional | 56 · Pre-op care only | $5.25 | $10.23 | $14.79 |
Where Tennessee sits
The same service costs 3.2 times more in Alaska than in Virginia. 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· 20th of 51
$132
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.