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 $44.67 Median $69.18 Typical High $112.20 | Professional | None | $44.67 | $69.18 | $112.20 |
Ambetter Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
BCBS Tennessee Setting Facility Modifier None Typical Low $371.54 Median $724.44 Typical High $1,862.09 | Facility | None | $371.54 | $724.44 | $1,862.09 |
BCBS Tennessee Setting Professional Modifier None Typical Low $57.54 Median $100.00 Typical High $186.21 | Professional | None | $57.54 | $100.00 | $186.21 |
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 $47.86 Median $75.86 Typical High $162.18 | Professional | None | $47.86 | $75.86 | $162.18 |
Lucent Health Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
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 $50.12 Median $97.72 Typical High $169.82 | Professional | None | $50.12 | $97.72 | $169.82 |
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 $20.42 Median $31.62 Typical High $47.86 | Professional | 52 · Reduced service | $20.42 | $31.62 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $12.59 Typical High $19.05 | Professional | 53 · Discontinued | $8.13 | $12.59 | $19.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $47.86 Typical High $72.44 | Professional | 54 · Surgery only | $30.90 | $47.86 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $9.55 Typical High $14.45 | Professional | 55 · Aftercare only | $6.17 | $9.55 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $6.31 Typical High $9.55 | Professional | 56 · Pre-op care only | $4.07 | $6.31 | $9.55 |
Where Tennessee sits
The same service costs 3.2 times more in Wisconsin 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· 14th of 51
$117
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.