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 $87.10 Median $120.23 Typical High $208.93 | Professional | None | $87.10 | $120.23 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $144.54 | Professional | None | $107.15 | $107.15 | $144.54 |
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 $97.72 Median $123.03 Typical High $208.93 | Professional | None | $97.72 | $123.03 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $144.54 Typical High $1,659.59 | Facility | None | $72.44 | $144.54 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $93.33 Typical High $204.17 | Professional | None | $75.86 | $93.33 | $204.17 |
Lucent Health Setting Professional Modifier None Typical Low $1,778.28 Median $3,235.94 Typical High $3,235.94 | Professional | None | $1,778.28 | $3,235.94 | $3,235.94 |
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 $93.33 Median $120.23 Typical High $245.47 | Professional | None | $93.33 | $120.23 | $245.47 |
6 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 $43.65 Median $53.70 Typical High $79.43 | Professional | 52 · Reduced service | $43.65 | $53.70 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $21.38 Typical High $31.62 | Professional | 53 · Discontinued | $17.38 | $21.38 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $79.43 Typical High $120.23 | Professional | 54 · Surgery only | $64.57 | $79.43 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $15.85 Typical High $23.99 | Professional | 55 · Aftercare only | $12.88 | $15.85 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $10.72 Typical High $15.85 | Professional | 56 · Pre-op care only | $8.71 | $10.72 | $15.85 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $158.49 Median $158.49 Typical High $213.80 | Professional | 50 · Both sides | $158.49 | $158.49 | $213.80 |
Where Tennessee sits
The same service costs 3.7 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· 20th of 51
$158
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.