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 $1,819.70 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,819.70 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $213.80 Typical High $2,570.40 | Professional | None | $147.91 | $213.80 | $2,570.40 |
BCBS Tennessee Setting Facility Modifier None Typical Low $1,000.00 Median $1,995.26 Typical High $5,128.61 | Facility | None | $1,000.00 | $1,995.26 | $5,128.61 |
BCBS Tennessee Setting Professional Modifier None Typical Low $257.04 Median $331.13 Typical High $549.54 | Professional | None | $257.04 | $331.13 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,511.89 Typical High $4,677.35 | Facility | None | $602.56 | $2,511.89 | $4,677.35 |
Lucent Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,187.76 Typical High $2,187.76 | Professional | None | $1,778.28 | $2,187.76 | $2,187.76 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,801.89 Typical High $6,760.83 | Facility | None | $1,202.26 | $3,801.89 | $6,760.83 |
United Setting Professional Modifier None Typical Low $218.78 Median $338.84 Typical High $549.54 | Professional | None | $218.78 | $338.84 | $549.54 |
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 $74.13 Median $85.11 Typical High $104.71 | Professional | 52 · Reduced service | $74.13 | $85.11 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $33.88 Typical High $42.66 | Professional | 53 · Discontinued | $29.51 | $33.88 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $125.89 Typical High $158.49 | Professional | 54 · Surgery only | $112.20 | $125.89 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $25.12 Typical High $31.62 | Professional | 55 · Aftercare only | $22.39 | $25.12 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $16.98 Typical High $21.38 | Professional | 56 · Pre-op care only | $14.79 | $16.98 | $21.38 |
Where Tennessee sits
The same service costs 10.7 times more in Colorado than in Maine. 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· 10th of 51
$1,778
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.