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 $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $141.25 | Professional | None | $107.15 | $107.15 | $141.25 |
Ambetter Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
BCBS Tennessee Setting Professional Modifier None Typical Low $144.54 Median $181.97 Typical High $181.97 | Professional | None | $144.54 | $181.97 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $158.49 | Facility | None | $151.36 | $151.36 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $151.36 | Professional | None | $112.20 | $112.20 | $151.36 |
Lucent Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,230.27 | $1,778.28 | $1,778.28 |
United Setting Professional Modifier None Typical Low $75.86 Median $114.82 Typical High $141.25 | Professional | None | $75.86 | $114.82 | $141.25 |
5 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 $52.48 Median $53.70 Typical High $58.88 | Professional | 52 · Reduced service | $52.48 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.88 Typical High $23.44 | Professional | 53 · Discontinued | $21.38 | $21.88 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $16.22 Typical High $17.78 | Professional | 55 · Aftercare only | $15.85 | $16.22 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.72 Typical High $11.75 | Professional | 56 · Pre-op care only | $10.72 | $10.72 | $11.75 |
Cigna Setting Professional Modifier RR · Rental Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | RR · Rental | $15.14 | $15.14 | $15.14 |
Where Tennessee sits
The same service costs 2.1 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· 38th of 51
$123
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.