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 $2,454.71 Median $2,818.38 Typical High $7,585.78 | Facility | None | $2,454.71 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $245.47 Typical High $316.23 | Professional | None | $213.80 | $245.47 | $316.23 |
BCBS Tennessee Setting Facility Modifier None Typical Low $489.78 Median $1,258.93 Typical High $3,715.35 | Facility | None | $489.78 | $1,258.93 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $19,498.45 | Facility | None | $512.86 | $512.86 | $19,498.45 |
Lucent Health Setting Professional Modifier None Typical Low $2,290.87 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,290.87 | $2,818.38 | $2,818.38 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,778.28 Typical High $3,981.07 | Facility | None | $501.19 | $1,778.28 | $3,981.07 |
United Setting Professional Modifier None Typical Low $316.23 Median $457.09 Typical High $724.44 | Professional | None | $316.23 | $457.09 | $724.44 |
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 $107.15 Median $123.03 Typical High $151.36 | Professional | 52 · Reduced service | $107.15 | $123.03 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $48.98 Typical High $61.66 | Professional | 53 · Discontinued | $42.66 | $48.98 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $181.97 Typical High $229.09 | Professional | 54 · Surgery only | $158.49 | $181.97 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $36.31 Typical High $45.71 | Professional | 55 · Aftercare only | $32.36 | $36.31 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $24.55 Typical High $30.20 | Professional | 56 · Pre-op care only | $21.38 | $24.55 | $30.20 |
Where Tennessee sits
The same service costs 6.3 times more in Texas than in Pennsylvania. 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
$955
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.