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 $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $125.89 Typical High $177.83 | Professional | None | $123.03 | $125.89 | $177.83 |
Ambetter Setting Professional Modifier None Typical Low $30.20 Median $154.88 Typical High $398.11 | Professional | None | $30.20 | $154.88 | $398.11 |
BCBS Tennessee Setting Professional Modifier None Typical Low $165.96 Median $208.93 Typical High $208.93 | Professional | None | $165.96 | $208.93 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $147.91 | Facility | None | $141.25 | $141.25 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $141.25 | Professional | None | $104.71 | $104.71 | $141.25 |
Lucent Health Setting Professional Modifier None Typical Low $1,412.54 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,412.54 | $2,041.74 | $2,041.74 |
United Setting Professional Modifier None Typical Low $87.10 Median $131.83 Typical High $173.78 | Professional | None | $87.10 | $131.83 | $173.78 |
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 $60.26 Median $61.66 Typical High $67.61 | Professional | 52 · Reduced service | $60.26 | $61.66 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $24.55 Typical High $26.92 | Professional | 53 · Discontinued | $24.55 | $24.55 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.62 Typical High $20.42 | Professional | 55 · Aftercare only | $18.20 | $18.62 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.30 Typical High $13.49 | Professional | 56 · Pre-op care only | $12.30 | $12.30 | $13.49 |
Where Tennessee sits
The same service costs 2.2 times more in Hawaii than in Delaware. 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· 44th of 51
$141
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.