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 $131.83 Median $151.36 Typical High $177.83 | Facility | None | $131.83 | $151.36 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $134.90 | Professional | None | $131.83 | $131.83 | $134.90 |
BCBS Tennessee Setting Professional Modifier None Typical Low $117.49 Median $120.23 Typical High $120.23 | Professional | None | $117.49 | $120.23 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $169.82 Typical High $218.78 | Facility | None | $120.23 | $169.82 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
United Setting Professional Modifier None Typical Low $120.23 Median $125.89 Typical High $331.13 | Professional | None | $120.23 | $125.89 | $331.13 |
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 $66.07 Median $66.07 Typical High $67.61 | Professional | 52 · Reduced service | $66.07 | $66.07 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $26.30 Typical High $26.92 | Professional | 53 · Discontinued | $26.30 | $26.30 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $20.42 | Professional | 55 · Aftercare only | $19.95 | $19.95 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $13.49 | Professional | 56 · Pre-op care only | $13.18 | $13.18 | $13.49 |
Where Tennessee sits
The same service costs 8.7 times more in Texas than in Kansas. 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· 27th of 51
$132
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.