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 $2,454.71 Median $2,818.38 Typical High $7,585.78 | Facility | None | $2,454.71 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $141.25 Typical High $251.19 | Professional | None | $128.82 | $141.25 | $251.19 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
BCBS Tennessee Setting Professional Modifier None Typical Low $104.71 Median $117.49 Typical High $177.83 | Professional | None | $104.71 | $117.49 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $223.87 Typical High $331.13 | Facility | None | $162.18 | $223.87 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $131.83 Typical High $199.53 | Professional | None | $100.00 | $131.83 | $199.53 |
Lucent Health Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,621.81 | $1,621.81 | $1,621.81 |
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 $104.71 Median $134.90 Typical High $223.87 | Professional | None | $104.71 | $134.90 | $223.87 |
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 $63.10 Median $66.07 Typical High $85.11 | Professional | 52 · Reduced service | $63.10 | $66.07 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $26.92 Typical High $33.88 | Professional | 53 · Discontinued | $25.70 | $26.92 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $100.00 Typical High $128.82 | Professional | 54 · Surgery only | $95.50 | $100.00 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.95 Typical High $25.70 | Professional | 55 · Aftercare only | $19.05 | $19.95 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $13.49 Typical High $16.98 | Professional | 56 · Pre-op care only | $12.59 | $13.49 | $16.98 |
Where Tennessee sits
The same service costs 3.2 times more in Alaska 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· 29th of 51
$151
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.