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 $104.71 Median $144.54 Typical High $199.53 | Professional | None | $104.71 | $144.54 | $199.53 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $275.42 Typical High $275.42 | Professional | None | $125.89 | $275.42 | $275.42 |
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 $131.83 Median $173.78 Typical High $239.88 | Professional | None | $131.83 | $173.78 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $120.23 Typical High $602.56 | Facility | None | $56.23 | $120.23 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $151.36 Typical High $245.47 | Professional | None | $104.71 | $151.36 | $245.47 |
Lucent Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,148.15 | $1,479.11 | $1,479.11 |
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 $102.33 Median $151.36 Typical High $281.84 | Professional | None | $102.33 | $151.36 | $281.84 |
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 $52.48 Median $70.79 Typical High $100.00 | Professional | 52 · Reduced service | $52.48 | $70.79 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $28.84 Typical High $39.81 | Professional | 53 · Discontinued | $20.89 | $28.84 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $107.15 Typical High $151.36 | Professional | 54 · Surgery only | $79.43 | $107.15 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $21.38 Typical High $30.20 | Professional | 55 · Aftercare only | $15.85 | $21.38 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $14.45 Typical High $19.95 | Professional | 56 · Pre-op care only | $10.47 | $14.45 | $19.95 |
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
$178
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.