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 $75.86 Median $109.65 Typical High $154.88 | Professional | None | $75.86 | $109.65 | $154.88 |
Ambetter Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $218.78 | Professional | None | $204.17 | $204.17 | $218.78 |
BCBS Tennessee Setting Facility Modifier None Typical Low $50.12 Median $125.89 Typical High $208.93 | Facility | None | $50.12 | $125.89 | $208.93 |
BCBS Tennessee Setting Professional Modifier None Typical Low $93.33 Median $125.89 Typical High $181.97 | Professional | None | $93.33 | $125.89 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,148.15 Typical High $2,691.53 | Facility | None | $562.34 | $1,148.15 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $109.65 Typical High $181.97 | Professional | None | $74.13 | $109.65 | $181.97 |
Lucent Health Setting Professional Modifier None Typical Low $851.14 Median $1,122.02 Typical High $1,122.02 | Professional | None | $851.14 | $1,122.02 | $1,122.02 |
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 $74.13 Median $112.20 Typical High $208.93 | Professional | None | $74.13 | $112.20 | $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 $37.15 Median $54.95 Typical High $77.62 | Professional | 52 · Reduced service | $37.15 | $54.95 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $21.88 Typical High $30.90 | Professional | 53 · Discontinued | $15.14 | $21.88 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $83.18 Typical High $114.82 | Professional | 54 · Surgery only | $56.23 | $83.18 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $16.60 Typical High $22.91 | Professional | 55 · Aftercare only | $11.22 | $16.60 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $10.96 Typical High $15.49 | Professional | 56 · Pre-op care only | $7.59 | $10.96 | $15.49 |
Where Tennessee sits
The same service costs 3.5 times more in Alaska than in Florida. 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
$129
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.