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 $120.23 Median $162.18 Typical High $229.09 | Professional | None | $120.23 | $162.18 | $229.09 |
Ambetter Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
BCBS Tennessee Setting Facility Modifier None Typical Low $398.11 Median $741.31 Typical High $1,862.09 | Facility | None | $398.11 | $741.31 | $1,862.09 |
BCBS Tennessee Setting Professional Modifier None Typical Low $151.36 Median $204.17 Typical High $275.42 | Professional | None | $151.36 | $204.17 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $131.83 Typical High $602.56 | Facility | None | $56.23 | $131.83 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $169.82 Typical High $281.84 | Professional | None | $120.23 | $169.82 | $281.84 |
Lucent Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,288.25 | $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 $120.23 Median $173.78 Typical High $323.59 | Professional | None | $120.23 | $173.78 | $323.59 |
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 $60.26 Median $81.28 Typical High $114.82 | Professional | 52 · Reduced service | $60.26 | $81.28 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $32.36 Typical High $45.71 | Professional | 53 · Discontinued | $23.99 | $32.36 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $123.03 Typical High $169.82 | Professional | 54 · Surgery only | $91.20 | $123.03 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $24.55 Typical High $34.67 | Professional | 55 · Aftercare only | $18.20 | $24.55 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $16.22 Typical High $22.91 | Professional | 56 · Pre-op care only | $12.02 | $16.22 | $22.91 |
Where Tennessee sits
The same service costs 3.6 times more in Alaska than in Kentucky. 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· 28th of 51
$209
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.