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 $173.78 Median $199.53 Typical High $302.00 | Professional | None | $173.78 | $199.53 | $302.00 |
BCBS Tennessee Setting Facility Modifier None Typical Low $524.81 Median $1,000.00 Typical High $2,238.72 | Facility | None | $524.81 | $1,000.00 | $2,238.72 |
BCBS Tennessee Setting Professional Modifier None Typical Low $239.88 Median $331.13 Typical High $616.60 | Professional | None | $239.88 | $331.13 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $933.25 Typical High $1,659.59 | Facility | None | $512.86 | $933.25 | $1,659.59 |
Lucent Health Setting Professional Modifier None Typical Low $1,995.26 Median $2,454.71 Typical High $2,454.71 | Professional | None | $1,995.26 | $2,454.71 | $2,454.71 |
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 $257.04 Median $371.54 Typical High $602.56 | Professional | None | $257.04 | $371.54 | $602.56 |
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 $87.10 Median $100.00 Typical High $125.89 | Professional | 52 · Reduced service | $87.10 | $100.00 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $39.81 Typical High $50.12 | Professional | 53 · Discontinued | $34.67 | $39.81 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $147.91 Typical High $186.21 | Professional | 54 · Surgery only | $131.83 | $147.91 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $30.20 Typical High $37.15 | Professional | 55 · Aftercare only | $26.30 | $30.20 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $19.95 Typical High $25.12 | Professional | 56 · Pre-op care only | $17.38 | $19.95 | $25.12 |
Where Tennessee sits
The same service costs 8.3 times more in Alaska 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· 13th of 51
$437
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.