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 $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $177.83 Typical High $295.12 | Professional | None | $173.78 | $177.83 | $295.12 |
Ambetter Setting Professional Modifier None Typical Low $123.03 Median $263.03 Typical High $562.34 | Professional | None | $123.03 | $263.03 | $562.34 |
BCBS Tennessee Setting Professional Modifier None Typical Low $295.12 Median $309.03 Typical High $309.03 | Professional | None | $295.12 | $309.03 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $316.23 | Facility | None | $302.00 | $302.00 | $316.23 |
Cigna Setting Facility Modifier RR · Rental Typical Low $30.20 Median $30.20 Typical High $31.62 | Facility | RR · Rental | $30.20 | $30.20 | $31.62 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $302.00 | Professional | None | $218.78 | $218.78 | $302.00 |
Cigna Setting Professional Modifier RR · Rental Typical Low $25.70 Median $25.70 Typical High $30.20 | Professional | RR · Rental | $25.70 | $25.70 | $30.20 |
Lucent Health Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
United Setting Professional Modifier None Typical Low $154.88 Median $239.88 Typical High $309.03 | Professional | None | $154.88 | $239.88 | $309.03 |
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 $87.10 Median $89.13 Typical High $97.72 | Professional | 52 · Reduced service | $87.10 | $89.13 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $35.48 Typical High $38.90 | Professional | 53 · Discontinued | $34.67 | $35.48 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $26.92 Typical High $29.51 | Professional | 55 · Aftercare only | $26.30 | $26.92 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.78 Typical High $19.50 | Professional | 56 · Pre-op care only | $17.38 | $17.78 | $19.50 |
Where Tennessee sits
The same service costs 2.6 times more in Hawaii than in Utah. 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· 33rd of 51
$251
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.