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 $1,819.70 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,819.70 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $19.95 Median $28.18 Typical High $58.88 | Professional | None | $19.95 | $28.18 | $58.88 |
Ambetter Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
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 $22.91 Median $57.54 Typical High $75.86 | Professional | None | $22.91 | $57.54 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $1,659.59 | Facility | None | $50.12 | $66.07 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $15.85 Median $18.62 Typical High $69.18 | Professional | None | $15.85 | $18.62 | $69.18 |
Lucent Health Setting Professional Modifier None Typical Low $407.38 Median $660.69 Typical High $660.69 | Professional | None | $407.38 | $660.69 | $660.69 |
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 $24.55 Median $43.65 Typical High $79.43 | Professional | None | $24.55 | $43.65 | $79.43 |
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 $10.00 Median $10.47 Typical High $15.85 | Professional | 52 · Reduced service | $10.00 | $10.47 | $15.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.98 Median $4.27 Typical High $6.31 | Professional | 53 · Discontinued | $3.98 | $4.27 | $6.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $14.79 Median $15.85 Typical High $23.99 | Professional | 54 · Surgery only | $14.79 | $15.85 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.16 Typical High $4.79 | Professional | 55 · Aftercare only | $3.02 | $3.16 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.00 Median $2.14 Typical High $3.16 | Professional | 56 · Pre-op care only | $2.00 | $2.14 | $3.16 |
Where Tennessee sits
The same service costs 4.3 times more in Wyoming than in New York. 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· 4th of 51
$61.66
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.