How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $275.42 Median $275.42 Typical High $575.44 | Facility | None | $275.42 | $275.42 | $575.44 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $288.40 Typical High $380.19 | Professional | None | $275.42 | $288.40 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $295.12 | Professional | None | $275.42 | $275.42 | $295.12 |
BCBS Tennessee Setting Professional Modifier None Typical Low $218.78 Median $257.04 Typical High $489.78 | Professional | None | $218.78 | $257.04 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $691.83 | Facility | None | $588.84 | $588.84 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $275.42 Typical High $426.58 | Professional | None | $234.42 | $275.42 | $426.58 |
Lucent Health Setting Professional Modifier None Typical Low $1,905.46 Median $2,630.27 Typical High $2,630.27 | Professional | None | $1,905.46 | $2,630.27 | $2,630.27 |
United Setting Professional Modifier None Typical Low $208.93 Median $239.88 Typical High $478.63 | Professional | None | $208.93 | $239.88 | $478.63 |
4 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 $134.90 Median $144.54 Typical High $190.55 | Professional | 52 · Reduced service | $134.90 | $144.54 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $57.54 Typical High $75.86 | Professional | 53 · Discontinued | $54.95 | $57.54 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $42.66 Typical High $57.54 | Professional | 55 · Aftercare only | $40.74 | $42.66 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $28.84 Typical High $38.02 | Professional | 56 · Pre-op care only | $27.54 | $28.84 | $38.02 |
Where Tennessee sits
The same service costs 2.8 times more in Alaska 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· 34th of 51
$295
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.