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 $2,089.30 Median $2,818.38 Typical High $7,585.78 | Facility | None | $2,089.30 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $2,818.38 Median $5,011.87 Typical High $6,309.57 | Professional | None | $2,818.38 | $5,011.87 | $6,309.57 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,819.70 Median $4,897.79 Typical High $10,471.29 | Facility | None | $1,819.70 | $4,897.79 | $10,471.29 |
BCBS Tennessee Setting Professional Modifier None Typical Low $10,964.78 Median $13,803.84 Typical High $23,442.29 | Professional | None | $10,964.78 | $13,803.84 | $23,442.29 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $9,332.54 Typical High $18,620.87 | Facility | None | $602.56 | $9,332.54 | $18,620.87 |
Lucent Health Setting Professional Modifier None Typical Low $47,863.01 Median $47,863.01 Typical High $47,863.01 | Professional | None | $47,863.01 | $47,863.01 | $47,863.01 |
United Setting Facility Modifier None Typical Low $3,630.78 Median $10,000.00 Typical High $15,848.93 | Facility | None | $3,630.78 | $10,000.00 | $15,848.93 |
United Setting Professional Modifier None Typical Low $9,549.93 Median $14,791.08 Typical High $23,442.29 | Professional | None | $9,549.93 | $14,791.08 | $23,442.29 |
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 $2,187.76 Median $2,511.89 Typical High $3,090.30 | Professional | 52 · Reduced service | $2,187.76 | $2,511.89 | $3,090.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $870.96 Median $1,000.00 Typical High $1,258.93 | Professional | 53 · Discontinued | $870.96 | $1,000.00 | $1,258.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,311.31 Median $3,715.35 Typical High $4,677.35 | Professional | 54 · Surgery only | $3,311.31 | $3,715.35 | $4,677.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $660.69 Median $741.31 Typical High $933.25 | Professional | 55 · Aftercare only | $660.69 | $741.31 | $933.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $436.52 Median $501.19 Typical High $630.96 | Professional | 56 · Pre-op care only | $436.52 | $501.19 | $630.96 |
Where Tennessee sits
The same service costs 16.6 times more in Indiana than in Nebraska. 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· 42nd of 51
$8,128
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.