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 $389.05 Median $389.05 Typical High $575.44 | Facility | None | $389.05 | $389.05 | $575.44 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $398.11 | Professional | None | $389.05 | $389.05 | $398.11 |
BCBS Tennessee Setting Professional Modifier None Typical Low $380.19 Median $389.05 Typical High $389.05 | Professional | None | $380.19 | $389.05 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $501.19 Typical High $645.65 | Facility | None | $380.19 | $501.19 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
United Setting Professional Modifier None Typical Low $380.19 Median $407.38 Typical High $489.78 | Professional | None | $380.19 | $407.38 | $489.78 |
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 $194.98 Median $194.98 Typical High $199.53 | Professional | 52 · Reduced service | $194.98 | $194.98 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $77.62 Typical High $79.43 | Professional | 53 · Discontinued | $77.62 | $77.62 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $60.26 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $39.81 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $39.81 |
Where Tennessee sits
The same service costs 11.5 times more in Alabama than in Oklahoma. 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· 44th of 51
$389
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.