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 $107.15 Median $162.18 Typical High $229.09 | Professional | None | $107.15 | $162.18 | $229.09 |
Ambetter Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $302.00 | Professional | None | $162.18 | $162.18 | $302.00 |
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 $134.90 Median $177.83 Typical High $269.15 | Professional | None | $134.90 | $177.83 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $151.36 Typical High $602.56 | Facility | None | $56.23 | $151.36 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $162.18 Typical High $263.03 | Professional | None | $104.71 | $162.18 | $263.03 |
Lucent Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,258.93 | $1,659.59 | $1,659.59 |
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 $104.71 Median $162.18 Typical High $302.00 | Professional | None | $104.71 | $162.18 | $302.00 |
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 $53.70 Median $79.43 Typical High $112.20 | Professional | 52 · Reduced service | $53.70 | $79.43 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $31.62 Typical High $45.71 | Professional | 53 · Discontinued | $21.38 | $31.62 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $117.49 Typical High $169.82 | Professional | 54 · Surgery only | $81.28 | $117.49 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $23.44 Typical High $33.88 | Professional | 55 · Aftercare only | $16.22 | $23.44 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $15.85 Typical High $22.39 | Professional | 56 · Pre-op care only | $10.72 | $15.85 | $22.39 |
Where Tennessee sits
The same service costs 3.3 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· 25th of 51
$191
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.