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 $190.55 Median $245.47 Typical High $288.40 | Facility | None | $190.55 | $245.47 | $288.40 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 52 · Reduced service | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | 53 · Discontinued | $38.02 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $19.05 |
Ambetter Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
BCBS Tennessee Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $190.55 | Professional | None | $186.21 | $186.21 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $245.47 Typical High $316.23 | Facility | None | $186.21 | $245.47 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
United Setting Professional Modifier None Typical Low $173.78 Median $186.21 Typical High $199.53 | Professional | None | $173.78 | $186.21 | $199.53 |
1 more rate 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier JW · Drug discarded Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | JW · Drug discarded | $186.21 | $186.21 | $186.21 |
Where Tennessee sits
Rates are fairly even across states for this service. 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· 30th of 51
$191
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.