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 $891.25 Median $2,290.87 Typical High $7,585.78 | Facility | None | $891.25 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $67.61 Typical High $97.72 | Professional | None | $47.86 | $67.61 | $97.72 |
BCBS Tennessee Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $1,905.46 | Facility | None | $407.38 | $812.83 | $1,905.46 |
BCBS Tennessee Setting Professional Modifier None Typical Low $69.18 Median $104.71 Typical High $154.88 | Professional | None | $69.18 | $104.71 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $75.86 Typical High $1,230.27 | Facility | None | $58.88 | $75.86 | $1,230.27 |
Lucent Health Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $851.14 | Professional | None | $724.44 | $851.14 | $851.14 |
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 $67.61 Median $102.33 Typical High $173.78 | Professional | None | $67.61 | $102.33 | $173.78 |
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 $22.91 Median $33.88 Typical High $48.98 | Professional | 52 · Reduced service | $22.91 | $33.88 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $13.49 Typical High $19.50 | Professional | 53 · Discontinued | $9.12 | $13.49 | $19.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $51.29 Typical High $72.44 | Professional | 54 · Surgery only | $33.88 | $51.29 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $10.23 Typical High $14.45 | Professional | 55 · Aftercare only | $6.76 | $10.23 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $6.76 Typical High $9.77 | Professional | 56 · Pre-op care only | $4.57 | $6.76 | $9.77 |
Where Tennessee sits
The same service costs 3.4 times more in Alaska than in Virginia. 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· 11th of 51
$141
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.