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 $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $165.96 Typical High $263.03 | Professional | None | $162.18 | $165.96 | $263.03 |
Ambetter Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $389.05 | Professional | None | $295.12 | $295.12 | $389.05 |
BCBS Tennessee Setting Professional Modifier None Typical Low $229.09 Median $295.12 Typical High $295.12 | Professional | None | $229.09 | $295.12 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $263.03 | Facility | None | $245.47 | $245.47 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $245.47 | Professional | None | $181.97 | $181.97 | $245.47 |
Lucent Health Setting Professional Modifier None Typical Low $2,570.40 Median $3,890.45 Typical High $3,890.45 | Professional | None | $2,570.40 | $3,890.45 | $3,890.45 |
United Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $245.47 | Facility | None | $190.55 | $190.55 | $245.47 |
United Setting Professional Modifier None Typical Low $125.89 Median $186.21 Typical High $288.40 | Professional | None | $125.89 | $186.21 | $288.40 |
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 $81.28 Median $83.18 Typical High $131.83 | Professional | 52 · Reduced service | $81.28 | $83.18 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $33.11 Typical High $52.48 | Professional | 53 · Discontinued | $32.36 | $33.11 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $24.55 Typical High $38.90 | Professional | 55 · Aftercare only | $24.55 | $24.55 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.60 Typical High $26.30 | Professional | 56 · Pre-op care only | $16.22 | $16.60 | $26.30 |
Where Tennessee sits
The same service costs 2.5 times more in Kansas than in Florida. 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
$229
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.