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 $281.84 Median $323.59 Typical High $1,819.70 | Professional | None | $281.84 | $323.59 | $1,819.70 |
BCBS Tennessee Setting Facility Modifier None Typical Low $870.96 Median $1,621.81 Typical High $3,467.37 | Facility | None | $870.96 | $1,621.81 | $3,467.37 |
BCBS Tennessee Setting Professional Modifier None Typical Low $467.74 Median $602.56 Typical High $977.24 | Professional | None | $467.74 | $602.56 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,445.44 Typical High $5,248.07 | Facility | None | $602.56 | $1,445.44 | $5,248.07 |
Lucent Health Setting Professional Modifier None Typical Low $2,511.89 Median $3,090.30 Typical High $3,090.30 | Professional | None | $2,511.89 | $3,090.30 | $3,090.30 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,445.44 Typical High $3,630.78 | Facility | None | $512.86 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $416.87 Median $660.69 Typical High $954.99 | Professional | None | $416.87 | $660.69 | $954.99 |
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 $141.25 Median $162.18 Typical High $204.17 | Professional | 52 · Reduced service | $141.25 | $162.18 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $64.57 Typical High $81.28 | Professional | 53 · Discontinued | $56.23 | $64.57 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $245.47 Typical High $302.00 | Professional | 54 · Surgery only | $213.80 | $245.47 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $48.98 Typical High $60.26 | Professional | 55 · Aftercare only | $42.66 | $48.98 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $32.36 Typical High $40.74 | Professional | 56 · Pre-op care only | $28.18 | $32.36 | $40.74 |
Where Tennessee sits
The same service costs 8.1 times more in Texas than in New York. 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· 6th of 51
$1,318
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.