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 $1,479.11 Median $2,454.71 Typical High $7,585.78 | Facility | None | $1,479.11 | $2,454.71 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,258.93 Typical High $1,548.82 | Professional | None | $977.24 | $1,258.93 | $1,548.82 |
BCBS Tennessee Setting Facility Modifier None Typical Low $3,388.44 Median $6,456.54 Typical High $13,182.57 | Facility | None | $3,388.44 | $6,456.54 | $13,182.57 |
BCBS Tennessee Setting Professional Modifier None Typical Low $1,513.56 Median $1,778.28 Typical High $2,511.89 | Professional | None | $1,513.56 | $1,778.28 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $12,882.50 Typical High $26,302.68 | Facility | None | $707.95 | $12,882.50 | $26,302.68 |
Lucent Health Setting Professional Modifier None Typical Low $10,232.93 Median $10,232.93 Typical High $12,589.25 | Professional | None | $10,232.93 | $10,232.93 | $12,589.25 |
United Setting Facility Modifier None Typical Low $5,888.44 Median $14,454.40 Typical High $26,915.35 | Facility | None | $5,888.44 | $14,454.40 | $26,915.35 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,584.89 Typical High $2,691.53 | Professional | None | $1,148.15 | $1,584.89 | $2,691.53 |
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 $489.78 Median $562.34 Typical High $691.83 | Professional | 52 · Reduced service | $489.78 | $562.34 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $223.87 Typical High $281.84 | Professional | 53 · Discontinued | $194.98 | $223.87 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $831.76 Typical High $1,047.13 | Professional | 54 · Surgery only | $741.31 | $831.76 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $165.96 Typical High $208.93 | Professional | 55 · Aftercare only | $147.91 | $165.96 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $112.20 Typical High $141.25 | Professional | 56 · Pre-op care only | $97.72 | $112.20 | $141.25 |
Where Tennessee sits
The same service costs 6.9 times more in Arkansas than in Kentucky. 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· 4th of 51
$5,888
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.