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 $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $537.03 Typical High $812.83 | Professional | None | $524.81 | $537.03 | $812.83 |
Ambetter Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,288.25 | Professional | None | $831.76 | $831.76 | $1,288.25 |
BCBS Tennessee Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $933.25 | Facility | None | $812.83 | $812.83 | $933.25 |
Cigna Setting Facility Modifier RR · Rental Typical Low $81.28 Median $81.28 Typical High $85.11 | Facility | RR · Rental | $81.28 | $81.28 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $812.83 | Professional | None | $588.84 | $588.84 | $812.83 |
Cigna Setting Professional Modifier RR · Rental Typical Low $69.18 Median $69.18 Typical High $81.28 | Professional | RR · Rental | $69.18 | $69.18 | $81.28 |
Lucent Health Setting Professional Modifier None Typical Low $6,456.54 Median $6,456.54 Typical High $6,456.54 | Professional | None | $6,456.54 | $6,456.54 | $6,456.54 |
United Setting Professional Modifier None Typical Low $446.68 Median $776.25 Typical High $1,000.00 | Professional | None | $446.68 | $776.25 | $1,000.00 |
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 $263.03 Median $269.15 Typical High $295.12 | Professional | 52 · Reduced service | $263.03 | $269.15 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $107.15 Typical High $117.49 | Professional | 53 · Discontinued | $104.71 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $81.28 Typical High $89.13 | Professional | 55 · Aftercare only | $79.43 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $53.70 Typical High $58.88 | Professional | 56 · Pre-op care only | $52.48 | $53.70 | $58.88 |
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· 18th of 51
$813
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.