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 $27.54 Median $2,137.96 Typical High $7,585.78 | Facility | None | $27.54 | $2,137.96 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $11.75 Median $16.60 Typical High $28.84 | Professional | None | $11.75 | $16.60 | $28.84 |
Ambetter Setting Professional Modifier None Typical Low $12.02 Median $15.49 Typical High $22.39 | Professional | None | $12.02 | $15.49 | $22.39 |
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 $13.18 Median $17.78 Typical High $32.36 | Professional | None | $13.18 | $17.78 | $32.36 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $537.03 Typical High $1,659.59 | Facility | None | $52.48 | $537.03 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $12.88 Median $16.22 Typical High $26.92 | Professional | None | $12.88 | $16.22 | $26.92 |
Lucent Health Setting Professional Modifier None Typical Low $112.20 Median $147.91 Typical High $147.91 | Professional | None | $112.20 | $147.91 | $147.91 |
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 $12.59 Median $16.98 Typical High $31.62 | Professional | None | $12.59 | $16.98 | $31.62 |
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 $5.89 Median $6.31 Typical High $9.12 | Professional | 52 · Reduced service | $5.89 | $6.31 | $9.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.34 Median $2.51 Typical High $3.63 | Professional | 53 · Discontinued | $2.34 | $2.51 | $3.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.71 Median $9.55 Typical High $13.49 | Professional | 54 · Surgery only | $8.71 | $9.55 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.74 Median $1.91 Typical High $2.69 | Professional | 55 · Aftercare only | $1.74 | $1.91 | $2.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.17 Median $1.26 Typical High $1.82 | Professional | 56 · Pre-op care only | $1.17 | $1.26 | $1.82 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $18.20 Median $23.44 Typical High $36.31 | Professional | 50 · Both sides | $18.20 | $23.44 | $36.31 |
Where Tennessee sits
The same service costs 7.4 times more in Kansas 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· 7th of 51
$38.02
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.