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 $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $281.84 Typical High $363.08 | Professional | None | $275.42 | $281.84 | $363.08 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $138.04 Median $141.25 Typical High $177.83 | Professional | 52 · Reduced service | $138.04 | $141.25 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $56.23 Typical High $72.44 | Professional | 53 · Discontinued | $54.95 | $56.23 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $41.69 Typical High $53.70 | Professional | 55 · Aftercare only | $41.69 | $41.69 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $28.18 Typical High $35.48 | Professional | 56 · Pre-op care only | $27.54 | $28.18 | $35.48 |
Ambetter Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
BCBS Tennessee Setting Professional Modifier None Typical Low $371.54 Median $478.63 Typical High $478.63 | Professional | None | $371.54 | $478.63 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $549.54 | Facility | None | $524.81 | $524.81 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $524.81 | Professional | None | $380.19 | $380.19 | $524.81 |
Lucent Health Setting Professional Modifier None Typical Low $4,073.80 Median $6,309.57 Typical High $6,309.57 | Professional | None | $4,073.80 | $6,309.57 | $6,309.57 |
United Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $416.87 | Facility | None | $389.05 | $389.05 | $416.87 |
United Setting Professional Modifier None Typical Low $208.93 Median $295.12 Typical High $416.87 | Professional | None | $208.93 | $295.12 | $416.87 |
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 |
|---|---|---|---|---|---|
Cigna Setting Professional Modifier RR · Rental Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | RR · Rental | $52.48 | $52.48 | $52.48 |
Where Tennessee sits
The same service costs 2.8 times more in Hawaii than in Maryland. 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· 40th of 51
$380
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.