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 $40.74 Median $74.13 Typical High $107.15 | Professional | None | $40.74 | $74.13 | $107.15 |
Ambetter Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
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 $51.29 Median $81.28 Typical High $125.89 | Professional | None | $51.29 | $81.28 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $104.71 Typical High $1,659.59 | Facility | None | $52.48 | $104.71 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $100.00 Typical High $177.83 | Professional | None | $39.81 | $100.00 | $177.83 |
Lucent Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
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 $41.69 Median $87.10 Typical High $181.97 | Professional | None | $41.69 | $87.10 | $181.97 |
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 $20.42 Median $36.31 Typical High $51.29 | Professional | 52 · Reduced service | $20.42 | $36.31 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $14.79 Typical High $20.42 | Professional | 53 · Discontinued | $8.13 | $14.79 | $20.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $54.95 Typical High $77.62 | Professional | 54 · Surgery only | $30.20 | $54.95 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $10.96 Typical High $15.49 | Professional | 55 · Aftercare only | $6.03 | $10.96 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $7.41 Typical High $10.23 | Professional | 56 · Pre-op care only | $4.07 | $7.41 | $10.23 |
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· 22nd of 51
$100
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.