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 $75.86 Median $83.18 Typical High $234.42 | Facility | None | $75.86 | $83.18 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $77.62 Typical High $100.00 | Professional | None | $74.13 | $77.62 | $100.00 |
BCBS Tennessee Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $77.62 | Professional | None | $34.67 | $34.67 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $20.42 Median $38.90 Typical High $102.33 | Professional | None | $20.42 | $38.90 | $102.33 |
Lucent Health Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $758.58 | Professional | None | $575.44 | $575.44 | $758.58 |
United Setting Professional Modifier None Typical Low $33.11 Median $69.18 Typical High $77.62 | Professional | None | $33.11 | $69.18 | $77.62 |
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 $37.15 Median $38.90 Typical High $50.12 | Professional | 52 · Reduced service | $37.15 | $38.90 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $15.85 Typical High $19.95 | Professional | 53 · Discontinued | $14.79 | $15.85 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $58.88 Typical High $75.86 | Professional | 54 · Surgery only | $56.23 | $58.88 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.75 Typical High $15.14 | Professional | 55 · Aftercare only | $11.22 | $11.75 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.76 Typical High $10.00 | Professional | 56 · Pre-op care only | $7.41 | $7.76 | $10.00 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | 59 · Distinct service | $56.23 | $56.23 | $56.23 |
Where Tennessee sits
The same service costs 4.5 times more in Alaska than in Ohio. 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· 27th of 51
$75.86
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.