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 $1,621.81 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,621.81 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $173.78 Typical High $234.42 | Professional | None | $151.36 | $173.78 | $234.42 |
BCBS Tennessee Setting Facility Modifier None Typical Low $50.12 Median $138.04 Typical High $1,000.00 | Facility | None | $50.12 | $138.04 | $1,000.00 |
BCBS Tennessee Setting Professional Modifier None Typical Low $223.87 Median $269.15 Typical High $371.54 | Professional | None | $223.87 | $269.15 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,258.93 Typical High $2,818.38 | Facility | None | $562.34 | $1,258.93 | $2,818.38 |
Lucent Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,380.38 | Professional | None | $1,288.25 | $1,288.25 | $1,380.38 |
United Setting Facility Modifier None Typical Low $107.15 Median $436.52 Typical High $1,778.28 | Facility | None | $107.15 | $436.52 | $1,778.28 |
United Setting Professional Modifier None Typical Low $186.21 Median $245.47 Typical High $426.58 | Professional | None | $186.21 | $245.47 | $426.58 |
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 $75.86 Median $87.10 Typical High $109.65 | Professional | 52 · Reduced service | $75.86 | $87.10 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $34.67 Typical High $43.65 | Professional | 53 · Discontinued | $30.20 | $34.67 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $131.83 Typical High $162.18 | Professional | 54 · Surgery only | $114.82 | $131.83 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $26.30 Typical High $32.36 | Professional | 55 · Aftercare only | $22.91 | $26.30 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $17.38 Typical High $21.88 | Professional | 56 · Pre-op care only | $15.14 | $17.38 | $21.88 |
Where Tennessee sits
The same service costs 18.6 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· 14th of 51
$302
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.